| Regimental number | 17204 |
| Place of birth | London England |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | Brisbane, Queensland |
| Marital status | Married |
| Age at embarkation | 35 |
| Next of kin | Wife, Mrs Clara Maud Shield, c/o Mrs Whatton, Moriaty Road, Chatswood, New South Wales |
| Enlistment date | 3 October 1916 |
| Rank on enlistment | Sapper |
| Unit name | February 1917 Reinforcements |
| AWM Embarkation Roll number | 14/42/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A46 Clan Mcgillivray on 10 May 1917 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 1-5 Division Field Company Engineers |
| Fate | Returned to Australia 19 December 1918 |
