| Regimental number | 14622 |
| Place of birth | Hillgrove New South Wales |
| Religion | Methodist |
| Occupation | Electrician |
| Address | Adelaide, South Australia |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs A Stephens, Hillgrove, New South Wales |
| Enlistment date | 31 December 1915 |
| Rank on enlistment | Private |
| Unit name | Australian Army Medical Corps, July 1916 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A70 Ballarat on 12 August 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 14th Field Ambulance |
| Fate | Returned to Australia 21 January 1918 |
