| Regimental number | 7211 |
| Religion | Church of England |
| Occupation | Horseman |
| Address | 12 Bray Street, Bronte, Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 33 |
| Next of kin | Wife, M Blom,12 Bray Street, Bronte, Sydney, New South Wales |
| Enlistment date | 19 January 1917 |
| Rank on enlistment | Private |
| Unit name | 1st Battalion, 24th Reinforcement |
| AWM Embarkation Roll number | 23/18/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Osterley on 10 February 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Battalion |
| Fate | Returned to Australia 22 July 1917 |