| Regimental number | 936 |
| Place of birth | Hull England |
| Religion | Church of England |
| Occupation | Clerk |
| Address | c/o Mrs Valentine, Robert Street, Sandwell, Port Adelaide, South Australia |
| Marital status | Married |
| Age at embarkation | 37 |
| Next of kin | Wife, Mrs Theresa Sampson, c/o Mrs Valentine, Robert Street, Sandwell, Port Adelaide, South Australia |
| Enlistment date | 14 February 1916 |
| Rank on enlistment | Lance Corporal |
| Unit name | 43rd Battalion, Machine Gun Section |
| AWM Embarkation Roll number | 23/60/1 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A19 Afric on 9 June 1916 |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | 43rd Battalion |
| Fate | Returned to Australia 11 January 1918 |
