| Regimental number | 3110 |
| Place of birth | Windsor New South Wales |
| Religion | Church of England |
| Occupation | Butcher's labourer |
| Address | Granville, New South Wales |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs Eliza Potts, Parramatta Street, Granville, New South Wales |
| Enlistment date | 12 February 1917 |
| Rank on enlistment | Private |
| Unit name | 36th Battalion, 7th Reinforcement |
| AWM Embarkation Roll number | 23/53/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A24 Benalla on 10 May 1917 |
| Regimental number from Nominal Roll | 3110A |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 35th Battalion |
| Fate | Returned to Australia 25 January 1919 |