| Regimental number | 3917 |
| Place of birth | Goulburn New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Picton, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Friend, Mr R Cheethan, Picton, New South Wales |
| Enlistment date | 31 July 1917 |
| Date of enlistment from Nominal Roll | 31 July 1915 |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/21/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 30 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Battalion |
| Fate | Returned to Australia 27 August 1917 |
