| Regimental number | 2415 |
| Place of birth | Broken Hill New South Wales |
| Religion | Methodist |
| Occupation | Miner |
| Address | 310 Hay Street, Kalgoorlie, Western Australia |
| Marital status | Married |
| Age at embarkation | 27 |
| Next of kin | Wife, Mrs Eliza Verran, 310 Hay Street, Kalgoorlie, Western Australia |
| Enlistment date | 21 February 1916 |
| Rank on enlistment | Private |
| Unit name | 10th Light Horse Regiment, 16th Reinforcement |
| AWM Embarkation Roll number | 10/15/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A52 Surada on 16 May 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Light Horse Brigade Machine Gun Squadron |
| Fate | Returned to Australia 22 January 1917 |
