| Regimental number | 4664 |
| Place of birth | Cargelligo New South Wales |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | Cargelligo, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs Maria Smith, Cargelligo, New South Wales |
| Enlistment date | 25 October 1916 |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/47/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on 25 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 30th Battalion |
| Fate | Returned to Australia 8 April 1917 |
