| Regimental number | 2921 |
| Place of birth | Ballarat Victoria |
| Religion | Church of England |
| Occupation | Traveller |
| Address | 'Cooleena', Drynan Street, Summer Hill, New South Wales |
| Marital status | Married |
| Age at embarkation | 25 |
| Next of kin | Wife, Mrs Violet May Payne, 'Cooleena', Drynan Street, Summer Hill, New South Wales |
| Enlistment date | 30 May 1916 |
| Date of enlistment from Nominal Roll | 16 May 1916 |
| Rank on enlistment | Private |
| Unit name | 33rd Battalion, 6th Reinforcement |
| AWM Embarkation Roll number | 23/50/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on 25 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 33rd Battalion |
| Fate | Returned to Australia 25 August 1917 |
