| Regimental number | 4563 |
| Place of birth | Port Stevens New South Wales |
| Religion | Church of England |
| Occupation | Milk hand |
| Address | George Street, Waratah, North Newcastle, New South Wales |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Father, A Blanch, Swan Bay, Karuah PO, Port Stephens, New South Wales |
| Enlistment date | 11 January 1918 |
| Rank on enlistment | Private |
| Unit name | Light Horse, February 1918 Reinforcements |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Port Darwin on 30 April 1918 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 1st Light Horse Regiment |
| Fate | Returned to Australia 13 March 1919 |