| Regimental number | 2647 |
| Place of birth | Montgomery Wales |
| Religion | Methodist |
| Occupation | Platelayer |
| Address | Tancoed, Trefegleys, Llaindoes, Montgomeryshire, Wales |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs J Thomas, Tancoed, Trefegleys, Llaindoes, Montgomeryshire, Wales |
| Enlistment date | 10 February 1915 |
| Rank on enlistment | Driver |
| Unit name | 4th Light Horse Field Ambulance |
| Embarkation details | Unit embarked from on board HMAT A30 Borda on 16 June 1915 |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 15th Field Company Engineers |
| Fate | Returned to Australia 21 March 1919 |
