| Regimental number | 6566 |
| Place of birth | Greens Plains West South Australia |
| Religion | Methodist |
| Occupation | Farmer |
| Address | Kadina, South Australia |
| Marital status | Married |
| Age at embarkation | 35 |
| Next of kin | Wife, Mrs F Petherick, Kadina, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/27/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A16 Port Melbourne on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 10th Battalion |
| Fate | Returned to Australia |
| Other details |
War service: Western Front Medals: British War Medal, Victory Medal |
| Date of death | |
| Age at death | 73 |
| Place of burial | Kadina Cemetery, South Australia |
