| Regimental number | 4192 |
| Place of birth | Lithgow New South Wales |
| Religion | Methodist |
| Occupation | Labourer |
| Address | c/o Mrs Ellery, Sydney Road, Manly, New South Wales |
| Marital status | Single |
| Age at embarkation | 34 |
| Next of kin | Mother, Mrs G Owen c/o Mrs Ellery, Sydney Road, Manly, New South Wales |
| Enlistment date | 12 October 1915 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/34/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A15 Star Of England on 8 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 17th Battalion |
| Fate | Effective abroad (still overseas) |
