| Regimental number | 2191 |
| Place of birth | Llanboidy Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Apple Tree Creek, Childers, Queensland |
| Marital status | Married |
| Age at embarkation | 42 |
| Next of kin | Wife, Mrs Emma Rees, Pont Henry, Llanelly, South Wales |
| Enlistment date | 3 March 1916 |
| Rank on enlistment | Private |
| Unit name | 4th Pioneer Battalion, Reinforcement 3 |
| AWM Embarkation Roll number | 14/16/3 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A46 Clan Macgillivray on 1 May 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Battalion |
| Fate | Returned to Australia 27 August 1917 |
