| Regimental number | 4196 |
| Place of birth | Mickley England |
| Religion | Church of England |
| Occupation | Fireman |
| Address | North Rathbury, near Branxton, New South Wales |
| Marital status | Widower |
| Age at embarkation | 32 |
| Next of kin | Aunt, Mrs Elizabeth Jane Tait, High Mickley, Stocksfield-on-Tyne, England |
| Enlistment date | 3 April 1917 |
| Rank on enlistment | Private |
| Unit name | 1st Pioneer Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 14/13/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on 16 June 1917 |
