| Regimental number | 3910 |
| Place of birth | Mudgee, New South Wales |
| Religion | Church of England |
| Occupation | Bootmaker |
| Address | Campbelltown, New South Wales |
| Marital status | Single |
| Age at embarkation | 31 |
| Height | 5' 7" |
| Weight | 146 lbs |
| Next of kin | Sister, S Kellar, Campbelltown, New South Wales |
| Previous military service | Nil |
| Enlistment date | |
| Place of enlistment | Holsworthy, New South Wales |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 23/36/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A54 Runic on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 55 Battalionth |
| Fate | Returned to Australia |
| Discharge date | |
| Other details |
War service: Egypt, Western Front Commenced return to Australia on board HT 'Ayrshire', 23 May 1917' discharged (medically unfit: accidental gun shot wound, left foot), Sydney, 23 August 1917. Medals: British War Medal, Victory Medal |
| Sources | NAA: B2455, RIXON Hubert |