| Regimental number | 2004 |
| Place of birth | Penrith New South Wales |
| Religion | Church of England |
| Occupation | Cordial maker |
| Address | 16 Barnett Street, Fremantle, Western Australia |
| Marital status | Married |
| Age at embarkation | 42 |
| Next of kin | Cousin, Mr Evered Summons, Penrith, New South Wales |
| Enlistment date | 6 March 1916 |
| Date of enlistment from Nominal Roll | 20 March 1916 |
| Rank on enlistment | Private |
| Unit name | 51st Battalion, 3rd Reinforcement |
| AWM Embarkation Roll number | 23/68/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A48 Seang Bee on 18 July 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 44th Battalion |
| Fate | Returned to Australia 4 May 1917 |
