| Regimental number | 1201 |
| Place of birth | Parkside South Australia |
| Religion | Church of England |
| Occupation | Labourer |
| Address | c/o Mrs N R Sampson, Mill Street, Dulwich, South Australia |
| Marital status | Married |
| Age at embarkation | 23 |
| Next of kin | Wife, Mrs Ethel May Stephens, 8 Little Rundle Street, Kent Town, South Australia |
| Enlistment date | 18 January 1915 |
| Rank on enlistment | Private |
| Unit name | 3rd Light Horse Regiment, 8th Reinforcement |
| AWM Embarkation Roll number | 10/8/2 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT Morea on 26 August 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Light Horse Regiment |
| Fate | Returned to Australia 30 August 1918 |
