| Regimental number | 17004 |
| Place of birth | Alexandra New Zealand |
| Religion | Roman Catholic |
| Occupation | Builder and contractor |
| Address | Togo parade, Leura, New South Wales |
| Marital status | Married |
| Age at embarkation | 42 |
| Next of kin | Wife, Mrs Isabella Nutt, Togo parade, Leura, New South Wales |
| Enlistment date | 23 October 1916 |
| Rank on enlistment | Sapper |
| Unit name | January 1917 Reinforcements |
| AWM Embarkation Roll number | 14/42/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Osterley on 10 February 1917 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 12th Field Company Engineers |
| Fate | Returned to Australia 10 January 1918 |
