| Regimental number | 5169 |
| Place of birth | Balmain New South Wales |
| Religion | Church of England |
| Occupation | Carter |
| Address | 18 Clare Street, Rozelle, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Father, J. Owen, 18 Clare Street, Rozelle, Sydney, New South Wales |
| Enlistment date | 16 January 1916 |
| Date of enlistment from Nominal Roll | 6 January 1916 |
| Rank on enlistment | Private |
| Unit name | 2nd Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/19/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A71 Nestor on 9 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Machine Gun Battalion |
| Fate | Returned to Australia 11 January 1918 |
