| Regimental number | 622 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Gasfitter's assistant |
| Address | 'Halstead', 10 Nowrainie Street, Summer Hill, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs Evelyn Mary Boulton, 'Halstead', 10 Nowrainie Street, Summer Hill, Sydney, New South Wales |
| Enlistment date | 29 November 1916 |
| Rank on enlistment | Private |
| Unit name | Machine Gun Company 9, Reinforcement 10 |
| AWM Embarkation Roll number | 24/14/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A29 Suevic on 21 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 33rd Battalion |
| Fate | Returned to Australia 12 December 1918 |
