| Regimental number | 2991 |
| Place of birth | Yarra, South Australia |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Forster, South Australia |
| Marital status | Married |
| Age at embarkation | 34 |
| Next of kin | Wife, Mrs. Ada Selma Paulina Bolt, Forster, South Australia |
| Enlistment date | 3 March 1916 |
| Date of enlistment from Nominal Roll | 30 March 1916 |
| Rank on enlistment | Private |
| Unit name | 3rd Light Horse Regiment, 22nd Reinforcement |
| AWM Embarkation Roll number | 10/8/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A65 Clan Mcewan on 9 October 1916 |
| Rank from Nominal Roll | Sergeant |
| Unit from Nominal Roll | 3rd Light Horse Regiment |
| Fate | Returned to Australia 11 July 1917 |
