| Regimental number | 2159 |
| Place of birth | Isle Of Wight, England |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 200 off Brown Street, East Perth, Western Australia |
| Marital status | Married |
| Age at embarkation | 33 |
| Next of kin | Ada Sampson, 200 Brown Street, East Perth, Western Australia |
| Enlistment date | 17 August 1914 |
| Place of enlistment | Blackboy Hill, Western Australia |
| Rank on enlistment | Gunner |
| Unit name | Field Artillery Brigade 3, Military District 5 |
| AWM Embarkation Roll number | 13/31/1 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board Transport A7 Medic on 2 November 1914 |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 1st AM CLM |
| Fate | Returned to Australia 12 April 1916 |
| Miscellaneous details (Nominal Roll) | *Second entry both matched |
