| Regimental number | 1679 |
| Place of birth | Avoca, Tasmania |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Fingal, Tasmania |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mother, Mrs. Mary Ann Bosworth, Fingal, Tasmania |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 3rd Light Horse Regiment, 12th Reinforcement |
| AWM Embarkation Roll number | 10/8/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A40 Ceramic on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Light Horse Regiment |
| Recommendations (Medals and Awards) |
Unspecified Recommendation date: |
| Fate | Returned to Australia |