| Regimental number | 6790 |
| Place of birth | Brisbane Queensland |
| Religion | Church of England |
| Occupation | Packer |
| Address | C/o Mrs Broadbent, Hazelbrook, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Sister, Miss R Roberts, C/o Mrs Prahal, St. Ronald, Ellis Street, Cooparoo via Brisbane, Queensland |
| Enlistment date | 23 August 1916 |
| Date of enlistment from Nominal Roll | 17 August 1916 |
| Rank on enlistment | Private |
| Unit name | 1st Battalion, 22nd Reinforcement |
| AWM Embarkation Roll number | 23/18/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT SS Port Nicholson on 8 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Battalion |
| Fate | Returned to Australia 6 July 1919 |
