| Regimental number | 5911 |
| Place of birth | Skerton England |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Nimbin, New South Wales |
| Marital status | Married |
| Age at embarkation | 28 |
| Next of kin | Wife, Mrs Elizabeth Shuttleworth, 54 Cable Street, Lancaster, Lancashire, England |
| Enlistment date | 2 June 1916 |
| Rank on enlistment | Private |
| Unit name | 25th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/42/4 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A36 Boonah on 21 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 25th Battalion |
| Fate | Returned to Australia 10 September 1917 |
