| Regimental number | 3969 |
| Place of birth | Wolverhampton England |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Bauple, Tiaro, North Coast Line, Queensland |
| Marital status | Single |
| Age at embarkation | 31 |
| Next of kin | Sister-in-Law, Mrs Agnes Thorne, C/- Valley Post Office, Valley, Brisbane, Queensland |
| Enlistment date | 12 October 1915 |
| Rank on enlistment | Private |
| Unit name | 25th Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 23/42/3 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT Wandilla on 31 January 1916 |