| Regimental number | 4784 |
| Place of birth | Toowoomba Queensland |
| Religion | Methodist |
| Occupation | Labourer |
| Address | Fitzroy Street, Grafton, New South Wales |
| Marital status | Married |
| Age at embarkation | 43 |
| Next of kin | Wife, Mrs Wilhemina Stockham, Fitzroy Street, Grafton, New South Wales |
| Enlistment date | 30 December 1915 |
| Rank on enlistment | Private |
| Unit name | 26th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/43/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Mooltan on 12 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 31st Battalion |
| Fate | Returned to Australia 17 March 1917 |
