| Regimental number | 6124 |
| Place of birth | Sydney New South Wales |
| Religion | Roman Catholic |
| Occupation | Slaughterman |
| Address | Macquarie Street, Windsor, New South Wales |
| Marital status | Single |
| Age at embarkation | 39 |
| Next of kin | Sister, Mrs Ann Mellish, Macquarie Street, Windsor, New South Wales |
| Enlistment date | 30 June 1916 |
| Date of enlistment from Nominal Roll | 29 June 1916 |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/36/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A11 Ascanius on 25 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 19th Battalion |
| Fate | Returned to Australia 30 January 1918 |
