| Regimental number | 21879 |
| Place of birth | Penzance England |
| Religion | Church of England |
| Occupation | Fireman |
| Address | 97 Renwick Street, Redfern, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Mother, Mrs S.J. Trevelyan, c/o Lea and Sons, 65-70 Western Road, Brighton, England |
| Enlistment date | 4 December 1917 |
| Rank on enlistment | Sapper |
| Unit name | Engineering Field Companies, General Reinforcements |
| AWM Embarkation Roll number | 14/42/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A54 Runic on 22 March 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 25th Depot Unit of Supply |
| Fate | Discharged 21 September 1919 |
