| Regimental number | 2017 |
| Place of birth | Swansea South Wales |
| Religion | Baptist |
| Occupation | Butcher |
| Address | Llangyfelach Road, Brynhyfrd, Swansea, South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs K Roberts, Llangyfelach Brynhyfrd, Swansea, Wales |
| Enlistment date | 19 January 1915 |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 5th Reinforcement |
| AWM Embarkation Roll number | 23/21/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A55 Kyarra on 13 April 1915 |
| Regimental number from Nominal Roll | 2017A |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | 1st Pioneer Battalion |
| Fate | Discharged 10 October 1919 |
