| Regimental number | 3399 |
| Place of birth | Cardiff Wales |
| Religion | Methodist |
| Occupation | Labourer |
| Marital status | Single |
| Age at embarkation | 36 |
| Next of kin | Father, D Rose,7 Davies Street, Moonee Ponds, Victoria |
| Enlistment date | 6 July 1915 |
| Rank on enlistment | Private |
| Unit name | 5th Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/22/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on 11 October 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 46th Battalion |
| Fate | Returned to Australia 4 May 1917 |
