| Regimental number | 6564 |
| Place of birth | Ballarat Victoria |
| Religion | Church of England |
| Occupation | Printer's |
| Address | Sunnyside, Court Street, Ashfield, New South Wales |
| Marital status | Single |
| Age at embarkation | 35 |
| Next of kin | Sister, Mrs M Russell, Sunnyside, Court Street, Ashfield, New South Wales |
| Enlistment date | 15 May 1916 |
| Rank on enlistment | Private |
| Unit name | 1st Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/18/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on 7 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Battalion |
| Fate | Returned to Australia 5 March 1919 |