| Regimental number | 4013 |
| Place of birth | Wollongong New South Wales |
| Religion | Church of England |
| Occupation | Bootmaker |
| Address | 336 Wellington Street, Perth, Western Australia |
| Marital status | Widower |
| Age at embarkation | 41 |
| Next of kin | Daughter, Miss Tollis, Richmond PO, Richmond, Victoria |
| Enlistment date | 8 March 1915 |
| Date of enlistment from Nominal Roll | 4 March 1915 |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/33/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A31 Ajana on 22 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 16th Battalion |
| Fate | Returned to Australia 11 April 1916 |