| Regimental number | 2159 |
| Place of birth | Nowrie New South Wales |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Mackay, Queensland |
| Marital status | Married |
| Age at embarkation | 42 |
| Next of kin | Wife, Mrs Elaine Elizabeth Laurie Shore, Marian via Mackay, Queensland |
| Enlistment date | 13 May 1916 |
| Rank on enlistment | Private |
| Unit name | 41st Battalion, 3rd Reinforcement |
| AWM Embarkation Roll number | 23/58/2 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A46 Clan Macgillivray on 7 September 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Returned to Australia 19 October 1918 |
