| Regimental number | 2409 |
| Place of birth | Ballarat Victoria |
| Religion | Methodist |
| Occupation | Braceman |
| Address | Aberdare Street, Kurri Kurri, New South Wales |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs George Northey, Aberdare Street, Kurri Kurri, New South Wales |
| Enlistment date | 14 September 1915 |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 4th Reinforcement |
| AWM Embarkation Roll number | 23/47/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A67 Orsova on 11 March 1916 |
| Rank from Nominal Roll | Private |
| Fate | Returned to Australia 8 April 1917 |
| Miscellaneous details (Nominal Roll) | Returned to Australia on board the "Barmah" |
| Discharge date | 10 July 1917 |