| Regimental number | 4769 |
| Place of birth | Hobart Tasmania |
| Religion | Church of England |
| Occupation | Boiler cleaner |
| Address | 73 Bridge Street, Camperdown, New South Wales |
| Marital status | Single |
| Age at embarkation | 31 |
| Next of kin | Mother, Mrs Jane Shaw, 73 Bridge Street, Camperdown, New South Wales |
| Enlistment date | 20 December 1915 |
| Date of enlistment from Nominal Roll | 9 December 1915 |
| Rank on enlistment | Private |
| Unit name | 20th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/37/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on 13 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 20th Battalion |
| Fate | Returned to Australia 12 December 1918 |