| Regimental number | 5405 |
| Place of birth | Inverell New South Wales |
| Religion | Church of England |
| Occupation | Linesman |
| Address | Newcastle PO, Newcastle, New South Wales |
| Marital status | Single |
| Age at embarkation | 34 |
| Next of kin | Mother, Mrs Mary Jane Rose, Bellbrook PO, Macleay River, New South Wales |
| Enlistment date | 26 May 1916 |
| Rank on enlistment | Sapper |
| Unit name | September 1916 Reinforcements |
| AWM Embarkation Roll number | 16/14/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A23 Suffolk on 29 September 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Tunnelling Company |
| Fate | Returned to Australia 23 May 1917 |
