| Regimental number | 5162 |
| Place of birth | Melbourne Victoria |
| Religion | Church of England |
| Occupation | Carpenter |
| Address | 30 Catherine Street, Subiaco, Western Australia |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs Mary Ann Sampford, 30 Catherine Street, Subiaco, Western Australia |
| Enlistment date | 10 November 1915 |
| Rank on enlistment | Sapper |
| Unit name | 3rd Field Company Engineers, Reinforcement 13 |
| AWM Embarkation Roll number | 14/22/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A35 Berrima on 17 December 1915 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 13th Field Company Engineers |
| Fate | Returned to Australia 17 October 1916 |
