| Regimental number | 17707 |
| Place of birth | Northamptonshire England |
| Religion | Church of England |
| Occupation | Builder's clerk |
| Address | Rose Park, South Australia |
| Marital status | Married |
| Age at embarkation | 29 |
| Next of kin | Wife, Mrs R Owen, 'Eggesford', Albert Street, Dulwich, South Australia |
| Enlistment date | 23 December 1916 |
| Rank on enlistment | Private |
| Unit name | April 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 1 August 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Australian General Hospital |
| Fate | Effective abroad (still overseas) |
