| Regimental number | 6716 |
| Place of birth | Marlborough Queensland |
| Religion | Protestant |
| Occupation | Labourer |
| Address | St Lawrence via Rockhampton, Queensland |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mother, Mrs H C Diver, Palace Hotel, Mackay, Queensland |
| Enlistment date | 19 September 1916 |
| Rank on enlistment | Private |
| Unit name | 15th Battalion, 22nd Reinforcement |
| AWM Embarkation Roll number | 23/32/2 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A55 Kyarra on 17 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 15th Battalion |
| Fate | Returned to Australia 12 March 1918 |
