| Regimental number | 5762 |
| Place of birth | Calcutta India |
| Religion | Methodist |
| Occupation | Coal lumper |
| Address | 31 Liverpool Street, Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 33 |
| Next of kin | Wife, Mrs V Roberts, 31 Liverpool Street, Sydney, New South Wales |
| Enlistment date | 7 February 1916 |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 18th Reinforcement |
| AWM Embarkation Roll number | 23/21/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A55 Kyarra on 3 June 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 54th Battalion |
| Fate | Returned to Australia 21 December 1917 |
