| Regimental number | 5452 |
| Place of birth | Rockdale England |
| Religion | Church of England |
| Occupation | Traveller |
| Address | 206 Hay Street, Subiaco, Western Australia |
| Marital status | Married |
| Age at embarkation | 28 |
| Next of kin | Wife, Mrs Bertha M Percival, 206 Hay Street, Subiaco, Western Australia |
| Enlistment date | 20 May 1915 |
| Rank on enlistment | Private |
| Unit name | Field Ambulance 4, Reinforcement 9 |
| AWM Embarkation Roll number | 26/47/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A20 Hororata on 1 October 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Field Ambulance |
| Fate | Discharged 19 December 1918 |
