| Regimental number | *9623 |
| Place of birth | Newcastle New South Wales |
| Religion | Church of England |
| Occupation | Seaman |
| Address | First Street, Weston, New South Wales |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs Elza Bourke, First Street, Weston, New South Wales |
| Enlistment date | 2 August 1915 |
| Rank on enlistment | Private |
| Unit name | Infantry Brigade 4, Field Ambulance 5, Reinforcement 10 |
| AWM Embarkation Roll number | 26/48/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A15 Star Of England on 8 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 9th Field Ambulance |
| Fate | Returned to Australia 28 February 1919 |
