| Regimental number | 5112 |
| Place of birth | Weldborough, Tasmania |
| Religion | Church of England |
| Occupation | Miner |
| Address | Carlton, Victoria |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Father, G Sams, 308 Cardigan Street, Carlton, Victoria |
| Enlistment date | 8 March 1917 |
| Place of enlistment | Melbourne, Victoria |
| Rank on enlistment | Private |
| Unit name | 29th Battalion, 14th Reinforcement |
| AWM Embarkation Roll number | 23/46/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A38 Ulysses on 22 December 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 29th Battalion |
| Fate | Returned to Australia 18 January 1919 |
