| Regimental number | 676 |
| Place of birth | West Wyalong New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Parkes Street, West Wyalong, New South Wales |
| Marital status | Single |
| Age at embarkation | 33 |
| Next of kin | Mother, Mrs Jane Flood Sam, Parkes Street, West Wyalong, New South Wales |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, B Company |
| AWM Embarkation Roll number | 23/34/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A32 Themistocles on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 17th Battalion |
| Fate | Returned to Australia |
| Other details |
Medals: 1914-15 Star, British War Medal, Victory Medal |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
