| Regimental number | 4515 |
| Place of birth | Birmingham England |
| Religion | Church of England |
| Occupation | Labourer |
| Address | c/o J W O'Hara, Yinnar, Victoria |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs Harriett Rose, 19 Alfred Street, Kings Heath, Birmingham, England |
| Enlistment date | 3 August 1915 |
| Rank on enlistment | Private |
| Unit name | 24th Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/41/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Malwa on 21 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 24th Battalion |
| Fate | Returned to Australia 29 May 1919 |
