| Regimental number | 5407 |
| Place of birth | Old Lambton New South Wales |
| Religion | Church of England |
| Occupation | Miner |
| Address | Vale of Clwydd, Lithgow, New South Wales |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Aunt, Mrs Margaret Stephenson, Vale of Clwydd, Lithgow, New South Wales |
| Enlistment date | 21 February 1916 |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 14th Reinforcement |
| AWM Embarkation Roll number | 23/36/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A18 Wiltshire on 22 August 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 17th Battalion |
| Fate | Returned to Australia 5 September 1919 |
