| Regimental number | 2782 |
| Place of birth | St George New South Wales |
| Religion | Roman Catholic |
| Occupation | Labourer and farrier |
| Address | Warwick, Queensland |
| Marital status | Single |
| Age at embarkation | 41 |
| Next of kin | Mother, Mrs Betsy Sampson, Chiltern, Victoria |
| Enlistment date | 1 December 1915 |
| Date of enlistment from Nominal Roll | 16 November 1916 |
| Rank on enlistment | Private |
| Unit name | 47th Battalion, 6th Reinforcement |
| AWM Embarkation Roll number | 23/64/3 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A74 Marathon on 27 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 47th Battalion |
| Fate | Returned to Australia 28 August 1919 |
