| Regimental number | 5104 |
| Place of birth | Horsham Victoria |
| Religion | Baptist |
| Occupation | Storekeeper |
| Address | Smith Street, Loch, Gippsland, Victoria |
| Marital status | Married |
| Age at embarkation | 34 |
| Next of kin | Wife, Mrs Rose Edna Trevan, Smith Street, Loch, Gippsland, Victoria |
| Enlistment date | 24 February 1916 |
| Rank on enlistment | Private |
| Unit name | 23rd Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/40/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A26 Armadale on 19 July 1916 |
| Rank from Nominal Roll | Lance Sergeant |
| Unit from Nominal Roll | 23rd Battalion |
| Fate | Returned to Australia 9 July 1919 |