| Regimental number | 1021 |
| Place of birth | Port Fairy Victoria |
| Religion | Roman Catholic |
| Occupation | Butter maker |
| Address | 86 Victoria Street, Coburg, Victoria |
| Marital status | Single |
| Age at embarkation | 29 |
| Next of kin | Mother, Mrs A Tennyson, 86 Victoria Street, Coburg, Victoria |
| Enlistment date | 19 January 1915 |
| Rank on enlistment | Private |
| Unit name | 22nd Battalion Head-Quarters Staff |
| AWM Embarkation Roll number | 23/39/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A38 Ulysses on 10 May 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Australian General Hospital |
| Fate | Returned to Australia 5 April 1918 |
