| Regimental number | 1790 |
| Place of birth | Woodburn New South Wales |
| Religion | Church of England |
| Occupation | Dairy farmer |
| Address | Bangalow, New South Wales |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs Ada Blanch, Cooraben Creek, Bangalow, New South Wales |
| Enlistment date | 7 April 1916 |
| Rank on enlistment | Private |
| Unit name | 41st Battalion, 2nd Reinforcement |
| AWM Embarkation Roll number | 23/58/2 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A42 Boorara on 16 August 1916 |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 41st Battalion |
| Fate | Returned to Australia 21 October 1917 |
