| Regimental number | 2564 |
| Place of birth | Hamilton New South Wales |
| Religion | Church of England |
| Occupation | Grocer |
| Address | Victoria Street, Kurri Kurri, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs Mary Raine, Victoria Street, Kurri Kurri, New South Wales |
| Enlistment date | 29 May 1917 |
| Date of enlistment from Nominal Roll | 29 April 1917 |
| Rank on enlistment | Private |
| Unit name | 12th Light Horse Regiment, 22nd Reinforcement |
| AWM Embarkation Roll number | 10/17/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A73 Commonwealth on 2 November 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 12th Light Horse Regiment |
| Fate | Returned to Australia 29 April 1919 |
