| Regimental number | 4196 |
| Place of birth | Cooma New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | c/o Mark Rollason, Temora PO, Temora, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | M Rollason, Temora PO, Temora, New South Wales |
| Enlistment date | 28 January 1915 |
| Date of enlistment from Nominal Roll | 27 January 1915 |
| Rank on enlistment | Driver |
| Unit name | Field Artillery Brigade 1, Reinforcement 5 |
| AWM Embarkation Roll number | 13/29/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A58 Kabinga on 17 May 1915 |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 1st Field Artillery Brigade |
| Fate | Returned to Australia 4 August 1915 |