| Regimental number | 421 |
| Place of birth | Bendigo Victoria |
| Religion | Church of England |
| Occupation | Well borer |
| Address | Young Street, Golden Square, Bendigo, Victoria |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mother, Mrs Ellen Potter, Young Street, Golden Square, Bendigo, Victoria |
| Enlistment date | 25 September 1916 |
| Rank on enlistment | Private |
| Unit name | Machine Gun Company 10, Reinforcement 5 |
| AWM Embarkation Roll number | 24/15/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A38 Ulysses on 25 October 1916 |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | 3rd Machine Gun Battalion |
| Fate | Returned to Australia 3 July 1919 |
