| Regimental number | 3636 |
| Place of birth | Port Melbourne Victoria |
| Religion | Roman Catholic |
| Occupation | Jockey |
| Address | Port Melbourne, Victoria |
| Marital status | Single |
| Age at embarkation | 32 |
| Next of kin | Uncle, J page, PO, Port Melbourne, Victoria |
| Enlistment date | 19 March 1917 |
| Rank on enlistment | Private |
| Unit name | 4th Light Horse Regiment, 28th Reinforcement |
| AWM Embarkation Roll number | 10/9/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A17 Port Lincoln on 22 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Light Horse Regiment |
| Fate | Returned to Australia 27 June 1919 |
