| Regimental number | 4609 |
| Place of birth | Brunswick Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Grafton Street, North Goulburn, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Friend, Mrs Alice O'Brian, Grafton Street, North Goulburn, New South Wales |
| Enlistment date | 4 November 1916 |
| Date of enlistment from Nominal Roll | 3 November 1916 |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/47/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on 25 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 30th Battalion |
| Fate | Returned to Australia 11 January 1918 |
