| Regimental number | 11109 |
| Place of birth | Melbourne Victoria |
| Religion | Church of England |
| Occupation | Musician |
| Address | Eagle Hotel, Hindley Street, Adelaide, South Australia |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs A. Place, same address |
| Enlistment date | 3 November 1915 |
| Rank on enlistment | Driver |
| Unit name | S.T25.16.3C25 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A19 Afric on 9 June 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 25th Company, Australian Army Service Corps |
| Fate | Returned to Australia 22 July 1917 |