| Regimental number | 7904 |
| Place of birth | Castlemaine Victoria |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Campbell Creek, Victoria |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Father, F Stephens, Campbell's Creek, Victoria |
| Enlistment date | 27 July 1915 |
| Date of enlistment from Nominal Roll | 17 July 1915 |
| Rank on enlistment | Private |
| Unit name | No 1 Australian General Hospital |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board A62 Wandilla on 25 June 1915 |
| Regimental number from Nominal Roll | 2904 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 13th Field Ambulance |
| Fate | Returned to Australia 28 March 1919 |