| Regimental number | 5677 |
| Place of birth | Rainalynch Victoria |
| Religion | Church of England |
| Occupation | Cook |
| Address | Lakes Entrance, Gippsland, Victoria |
| Marital status | Married |
| Age at embarkation | 38 |
| Next of kin | Wife, Mrs Lucy Pepper, Lakes Entrance, Gippsland, Victoria |
| Enlistment date | 8 May 1916 |
| Date of enlistment from Nominal Roll | 1 August 1916 |
| Rank on enlistment | Private |
| Unit name | 21st Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/38/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A9 Shropshire on 25 September 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Employment Company |
| Fate | Returned to Australia 6 June 1918 |
