| Regimental number | 4190 |
| Religion | Roman Catholic |
| Occupation | Assembler |
| Address | c/o Mrs Bishop, Thompson Road, North Fremantle, Western Australia |
| Marital status | Single |
| Age at embarkation | 43 |
| Next of kin | Mother, Mrs Ellen Ottaway, 21 Jersey Parade, Murrumbeena, Victoria |
| Enlistment date | 10 February 1916 |
| Date of enlistment from Nominal Roll | 10 January 1916 |
| Rank on enlistment | Private |
| Unit name | 28th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/45/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A38 Ulysses on 1 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 28th Battalion |
| Fate | Returned to Australia 22 February 1917 |