| Regimental number | 4179 |
| Place of birth | Bingara New South Wales |
| Religion | Church of England |
| Occupation | Road ganger |
| Address | 'Bonwick', Warialda, New South Wales |
| Marital status | Married |
| Age at embarkation | 45 |
| Next of kin | Wife, Mrs Jane Rose, 'Bonwick', Warialda, New South Wales |
| Enlistment date | 3 January 1917 |
| Rank on enlistment | Private |
| Unit name | 1st Pioneer Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 14/13/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on 16 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Pioneer Battalion |
| Fate | Returned to Australia 1 November 1917 |
