| Regimental number | 6058 |
| Place of birth | Collingwood Victoria |
| Religion | Roman Catholic |
| Occupation | Engineer's assistant |
| Address | 94 Michael Street, North Fitzroy, Victoria |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs J Douglas, 94 Michael Street, North Fitzroy, Victoria |
| Enlistment date | 29 April 1916 |
| Rank on enlistment | Private |
| Unit name | 5th Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/22/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A32 Themistocles on 28 July 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Battalion |
| Fate | Returned to Australia 9 February 1919 |
