| Regimental number | 4196 |
| Place of birth | Horsham Victoria |
| Religion | Presbyterian |
| Occupation | Farm hand |
| Marital status | Single |
| Age at embarkation | 39 |
| Next of kin | Mother, Mrs Elizabeth Potter, Lahaom, Mount Zero Private Bag Horsham, Victoria |
| Enlistment date | 18 October 1915 |
| Date of enlistment from Nominal Roll | 4 October 1915 |
| Rank on enlistment | Private |
| Unit name | 21st Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/38/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A18 Wiltshire on 7 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Division Train |
| Fate | Returned to Australia 10 December 1918 |
