| Regimental number | 16650 |
| Place of birth | Leicester England |
| Religion | Congregational |
| Occupation | Jeweller |
| Address | Kogarah, New South Wales |
| Marital status | Married |
| Age at embarkation | 27 |
| Next of kin | Wife, Mrs O A Sansome, 'Edington', Junction Street, Kogarah, New South Wales |
| Enlistment date | 21 March 1916 |
| Rank on enlistment | Private |
| Unit name | January 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Osterley on 10 February 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 10th Field Ambulance |
| Fate | Returned to Australia 3 September 1919 |
