| Regimental number | 7095 |
| Place of birth | Sydney New South Wales |
| Religion | Roman Catholic |
| Occupation | Driver |
| Address | Manly, New South Wales |
| Marital status | Married |
| Age at embarkation | 37 |
| Next of kin | Wife, Mrs O H Potter c/o T Dawe, Balgowlah Road, Manly, Sydney, New South Wales |
| Enlistment date | 20 August 1917 |
| Date of enlistment from Nominal Roll | 4 August 1917 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/34/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A14 Euripides on 31 October 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 17th Battalion |
| Fate | Returned to Australia 6 June 1918 |
