| Regimental number | 5689 |
| Place of birth | Surrey, England |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Manly, New South Wales |
| Marital status | Single |
| Age at embarkation | 29 |
| Next of kin | Sister, Mrs Maggie Moran, Darling Road, Manly, New South Wales |
| Enlistment date | 2 March 1916 |
| Place of enlistment | Cootamundra, New South Wales |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/36/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A14 Euripides on 9 September 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 19th Battalion |
| Fate | Returned to Australia 12 May 1918 |