| Regimental number | 15163 |
| Place of birth | Callington South Australia |
| Religion | Church of England |
| Occupation | Butcher |
| Address | 12 Forrest Street, Boulder City, Western Australia |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs L Tillett, 12 Forrest Street, Boulder City, Western Australia |
| Enlistment date | 13 November 1915 |
| Rank on enlistment | Gunner |
| Unit name | Field Artillery Brigade 10, Reinforcement 3 |
| AWM Embarkation Roll number | 13/37/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A35 Berrima on 4 July 1916 |
| Rank from Nominal Roll | Gunner |
| Unit from Nominal Roll | 16th Battalion |
| Fate | Returned to Australia 5 March 1919 |
