| Regimental number | 3668 |
| Place of birth | Gosford New South Wales |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Narara, Gosford, New South Wales |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs Jane Rose, Narara, Gosford, New South Wales |
| Enlistment date | 25 May 1917 |
| Rank on enlistment | Private |
| Unit name | 1st Light Horse Regiment, 33rd Reinforcement |
| AWM Embarkation Roll number | 10/6/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Canberra on 16 November 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Light Horse Field Ambulance |
| Fate | Returned to Australia 5 March 1919 |
