| Regimental number | 5403 |
| Place of birth | Port Fairy Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | London Boarding House, Wharf Street, Maryborough, Queensland |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs Elizabeth Ann Perry, 'The Oaks' Albert Street, Port Fairy, Victoria |
| Enlistment date | |
| Rank on enlistment | Sapper |
| Unit name | September 1916 Reinforcements |
| AWM Embarkation Roll number | 16/14/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A23 Suffolk on |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 1st Tunnelling Company |
| Fate | Returned to Australia |
| Miscellaneous information from cemetery records | Plaque in Victorian Garden of Remembrance |
| Date of death |