| Regimental number | 17233 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Storeman |
| Address | 126 West Street, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs E Southwell, 126 West Street, North Sydney, New South Wales |
| Enlistment date | 14 January 1916 |
| Rank on enlistment | Gunner |
| Unit name | Divisional Ammunition Column 4, Reinforcement 3 |
| AWM Embarkation Roll number | 25/111/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A69 Warilda on 22 May 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 55th Battalion |
| Fate | Returned to Australia 19 October 1917 |
