| Regimental number | 2022 |
| Place of birth | Wollun New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | c/o C Blaxhand, Woollum, New South Wales |
| Marital status | Single |
| Age at embarkation | 33 |
| Next of kin | Mother, Mrs George Tickle c/o C Blaxhand, Woollum, New South Wales |
| Enlistment date | 13 January 1915 |
| Rank on enlistment | Private |
| Unit name | 9th Battalion, 5th Reinforcement |
| AWM Embarkation Roll number | 23/26/2 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A55 Kyarra on 16 April 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 9th Battalion |
| Fate | Returned to Australia 19 October 1918 |
