| Regimental number | 3901 |
| Place of birth | Bathurst New South Wales |
| Religion | Church of England |
| Occupation | Fisherman |
| Address | 12 Samuel Street, St Peters, Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 32 |
| Next of kin | Sister, Mrs A E M Smith, 12 Samuel Street, St Peters, Sydney, New South Wales |
| Enlistment date | 25 August 1915 |
| Rank on enlistment | Private |
| Unit name | 2nd Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/19/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 30 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Battalion |
| Fate | Discharged 3 December 1916 |
