| Regimental number | 3410 |
| Place of birth | Ballarat Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Ballarat, Victoria |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs E J Smith, 2 Eastwood Street, Ballarat, Victoria |
| Enlistment date | 16 July 1915 |
| Rank on enlistment | Private |
| Unit name | 5th Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/22/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on 11 October 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Battalion |
| Fate | Returned to Australia 31 January 1918 |
