| Regimental number | 4616 |
| Place of birth | Marulan New South Wales |
| School | Bungonia Public School, New South Wales |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Tallong, New South Wales |
| Marital status | Married |
| Age at embarkation | 22 |
| Next of kin | Wife, Mrs Ethel Mary Tickner, Bradley Street, Goulburn, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/47/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 45th Battalion |
| Fate | Returned to Australia |
| Other details |
War service: Western Front Medals: British War Medal, Victory Medal |