| Regimental number | 1004 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Marrawah, Tasmania |
| Marital status | Married |
| Age at embarkation | 43 |
| Next of kin | Wife, Mrs Elizabeth Smith, Thompson Road, Marrawah, Tasmania |
| Enlistment date | 14 April 1916 |
| Rank on enlistment | Private |
| Unit name | 40th Battalion, A Company |
| AWM Embarkation Roll number | 23/57/1 |
| Embarkation details | Unit embarked from Hobart, Tasmania, on board HMAT A35 Berrima on 1 July 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 28th Battalion |
| Fate | Returned to Australia 17 December 1918 |