| Regimental number | 3987 |
| Place of birth | Geelong Victoria |
| Occupation | Labourer |
| Address | Germantown, Victoria |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs Eva Palmer, Germantown, Victoria |
| Enlistment date | 23 July 1915 |
| Date of enlistment from Nominal Roll | 13 July 1915 |
| Rank on enlistment | Private |
| Unit name | 22nd Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 23/39/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A69 Warilda on 8 February 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Machine Gun Battalion |
| Fate | Returned to Australia 9 February 1919 |