| Regimental number | 5763 |
| Place of birth | London England |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 60 Unwin Bridge Road, St Peters, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 37 |
| Next of kin | Sister, Mrs C Humphreys, 60 Unwin Bridge Road, St Peters, Sydney, New South Wales |
| Enlistment date | 11 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 5 November 1917 |
