| Regimental number | 4991 |
| Place of birth | Sydney New South Wales |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Marital status | Single |
| Age at embarkation | 37 |
| Next of kin | Ni, Miss Lennox Hayes, Newtown, Sydney, New South Wales |
| Enlistment date | 21 October 1916 |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 14th Reinforcement |
| AWM Embarkation Roll number | 23/47/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A74 Marathon on 10 May 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 30th Battalion |
| Fate | Discharged 10 December 1917 |
| Miscellaneous details (Nominal Roll) | *Second entry first one did not match |