| Regimental number | 4885 |
| Place of birth | Derby England |
| Religion | Church of England |
| Occupation | Soldier |
| Address | West Brunswick, Victoria |
| Marital status | Married |
| Age at embarkation | 45 |
| Next of kin | Wife, Mrs Emily Scrivener, 47 Murdoch Street, West Brunswick, Victoria |
| Enlistment date | 16 February 1917 |
| Rank on enlistment | Sergeant |
| Unit name | 29th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/46/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A29 Suevic on 21 June 1917 |
| Rank from Nominal Roll | Sergeant |
| Unit from Nominal Roll | 1st Convalescent Depot |
| Fate | Returned to Australia 2 January 1919 |
