| Regimental number | 2410 |
| Place of birth | Waterloo, Victoria |
| Religion | Presbyterian |
| Occupation | Clerk |
| Address | 118 Napier Street, South Melbourne, Victoria |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs H Provis, 114 Napier Street, South Melbourne, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 8th Battalion, 7th Reinforcement |
| AWM Embarkation Roll number | 23/25/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A64 Demosthenes on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 6th Battalion |
| Fate | Killed in Action |
| Age at death from cemetery records | 19 |
| Place of burial | Bedford House Cemetery (Plot I, Row E, Grave No. 5), Enclosure No. 4, Zillebeke, Belgium |
| Panel number, Roll of Honour, Australian War Memorial | 12 |
| Miscellaneous information from cemetery records | Paretns; Mr. and Mrs Helena PROVIS, 114 Napier Street, South Melbourne, Victoria |