| Regimental number | R1991 |
| Place of birth | Windsor Victoria |
| Religion | Church of England |
| Occupation | Clerk |
| Address | 65 St Vincents Place, Albert Park, Victoria |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mother, Mrs Francis Potter, 65 St Vincents Place, Albert Park, Victoria |
| Enlistment date | 14 February 1916 |
| Rank on enlistment | Private |
| Unit name | 39th Battalion, 2nd Reinforcement |
| AWM Embarkation Roll number | 23/56/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Orontes on 16 August 1916 |
| Regimental number from Nominal Roll | 1991 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 8th Battalion |
| Fate | Returned to Australia |
| Miscellaneous details (Nominal Roll) | *no date of fate |
