| Regimental number | 1258 |
| Place of birth | Waterloo Victoria |
| Religion | Presbyterian |
| Occupation | Labourer |
| Address | 114 Napier Street, South Melbourne, Victoria |
| Marital status | Married |
| Age at embarkation | 29 |
| Next of kin | Wife, Mrs E Provis, Meldrum Street, Wangaratta, Victoria |
| Enlistment date | 20 August 1914 |
| Rank on enlistment | Driver |
| Unit name | Field Artillery Brigade 2, Battery 6 |
| AWM Embarkation Roll number | 13/30/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A9 Shropshire on 20 October 1914 |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 2nd Field Artillery Brigade |
| Fate | Returned to Australia 24 September 1918 |
