| Regimental number | 6868 |
| Place of birth | Norwich England |
| Religion | Church of England |
| Occupation | Blacksmith |
| Address | Northam, Western Australia |
| Marital status | Married |
| Age at embarkation | 36 |
| Next of kin | Wife, Mrs Mary Louisa Percival, Midland Junction PO, Midland Junction, Western Australia |
| Enlistment date | 27 February 1917 |
| Date of enlistment from Nominal Roll | 23 February 1917 |
| Rank on enlistment | Private |
| Unit name | 28th Battalion, 20th Reinforcement |
| AWM Embarkation Roll number | 23/45/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A30 Borda on 29 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Flying Corps |
| Fate | Returned to Australia 8 August 1918 |
