| Regimental number | 6167 |
| Religion | Church of England |
| Occupation | Fitter |
| Address | 19 Arthur Street, Surry Hills, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 32 |
| Next of kin | Mother, Mrs Mary Anne Blackmore, 3 Brunton Avenue, Willsway, Bath, England |
| Enlistment date | 16 December 1915 |
| Rank on enlistment | Sapper |
| Unit name | 4th Field Company Engineers, Reinforcement 3 |
| AWM Embarkation Roll number | 14/23/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A54 Runic on 20 January 1916 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 7th Field Company Engineers |
| Fate | Returned to Australia 27 July 1917 |