| Regimental number | 289 |
| Place of birth | Sussex England |
| Religion | Church of England |
| Occupation | Sawyer |
| Address | Flint Street, N Ipswich, Queensland |
| Marital status | Married |
| Age at embarkation | 34 |
| Next of kin | Wife, Mrs Isabella Pettitt, Flint Street, N Ipswich, Queensland |
| Enlistment date | 19 February 1916 |
| Rank on enlistment | Private |
| Unit name | Machine Gun Company 12, Reinforcement 3 |
| AWM Embarkation Roll number | 24/17/3 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A46 Clan Macgillivray on 1 May 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Machine Gun Battalion |
| Fate | Returned to Australia 24 August 1918 |