| Regimental number | 1623 |
| Place of birth | Neurum Queensland |
| Religion | Methodist |
| Occupation | Labourer |
| Address | Neurum, Queensland |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs Caroline Black, Neurum, Queensland |
| Enlistment date | 3 January 1916 |
| Rank on enlistment | Private |
| Unit name | 47th Battalion, 2nd Reinforcement |
| AWM Embarkation Roll number | 23/64/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Hawkes Bay on 20 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 47th Battalion |
| Fate | Returned to Australia 12 November 1916 |