| Regimental number | 1403 |
| Place of birth | Broken Hill New South Wales |
| Religion | Methodist |
| Occupation | Miner |
| Address | Wirrabara, South Australia |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | ..., Mrs Jane Pascoe, Wirrabara, South Australia |
| Enlistment date | 8 October 1914 |
| Rank on enlistment | Private |
| Unit name | 14th Battalion, 2nd Reinforcement |
| AWM Embarkation Roll number | 23/31/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A46 Clan Macgillivray on 2 February 1915 |
| Regimental number from Nominal Roll | 1499 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 14th Battalion |
| Fate | Returned to Australia 14 December 1918 |
