| Regimental number | 5000 |
| Place of birth | London England |
| Religion | Church of England |
| Occupation | Labourer |
| Address | South Brisbane, Queensland |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs. Nellie Blake, Railway Street, off Dashon street, South Brisbane, Queensland |
| Enlistment date | 20 April 1917 |
| Rank on enlistment | Private |
| Unit name | 31st Battalion, 14th Reinforcement |
| AWM Embarkation Roll number | 23/48/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A20 Hororata on 14 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 31st Battalion |
| Fate | Returned to Australia 5 November 1917 |
