| Regimental number | 2221 |
| Place of birth | Mossgiel New South Wales |
| Religion | Church of England |
| Occupation | Shearer |
| Address | Bulli, South Coast, New South Wales |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs Elizabeth Moss, Bulli, South Coast, New South Wales |
| Enlistment date | 13 October 1915 |
| Rank on enlistment | Private |
| Unit name | 1st Light Horse Regiment, 15th Reinforcement |
| AWM Embarkation Roll number | 10/6/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A26 Armadale on 21 March 1916 |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 45th Battalion |
| Fate | Returned to Australia 26 September 1917 |
