| Regimental number | 5471 |
| Place of birth | Charters Towers Queensland |
| Religion | Methodist |
| Occupation | Labourer |
| Address | 172 Hopkins Street, Boulder, Western Australia |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs J B Stacey, 172 Hopkins Street, Boulder, Western Australia |
| Enlistment date | 9 February 1916 |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/28/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A60 Aeneas on 17 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Battalion |
| Fate | Returned to Australia 16 March 1919 |