| Regimental number | 9719 |
| Place of birth | Adelaide South Australia |
| Religion | Church of England |
| Occupation | Carpenter |
| Address | Mount Barker, South Australia |
| Marital status | Married |
| Age at embarkation | 25 |
| Next of kin | Wife, Mrs Ethel May Paine, Mount Barker, South Australia |
| Enlistment date | 29 January 1916 |
| Rank on enlistment | Sapper |
| Unit name | 11th Field Company Engineers, Section 2 |
| AWM Embarkation Roll number | 14/30/1 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A29 Suevic on 31 May 1916 |
| Regimental number from Nominal Roll | 9719a |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 11th Field Company Engineers |
| Fate | Returned to Australia 6 November 1918 |
