| Regimental number | 5176 |
| Place of birth | Port Melbourne Victoria |
| Religion | Church of England |
| Occupation | Soap mixer |
| Address | 35 Derham Street, Port Melbourne, Victoria |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs R Rook, 35 Derham Street, Port Melbourne, Victoria |
| Enlistment date | 22 January 1916 |
| Rank on enlistment | Private |
| Unit name | 6th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/23/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A23 Suffolk on 1 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Battalion |
| Fate | Returned to Australia 5 April 1918 |
