| Regimental number | 5967 |
| Place of birth | Stratford, Victoria |
| Religion | Church of England |
| Occupation | Grocer |
| Address | 2 Camberwell Grove, Upper Hawthorn, Victoria |
| Marital status | Single |
| Age at embarkation | 41 |
| Next of kin | Mother, Mrs S Bomford, 2 Camberwell Grove, Upper Hawthorn, Victoria |
| Enlistment date | 31 January 1916 |
| Rank on enlistment | Private |
| Unit name | 5th Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/22/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A32 Themistocles on 28 July 1916 |
| Regimental number from Nominal Roll | 5967A |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 39th Battalion |
| Fate | Returned to Australia 21 December 1917 |
