| Regimental number | 4109 |
| Place of birth | Plymouth England |
| Religion | Church of England |
| Occupation | Milk vendor |
| Address | 2 Church Street, Croydon, New South Wales |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Father, John Shepherd, Plymouth, Devon, England |
| Enlistment date | 4 May 1916 |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/47/3 |
| 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 | 30th Battalion |
| Fate | Returned to Australia 5 April 1918 |
