| Regimental number | 6647 |
| Place of birth | Fakenham England |
| Religion | Church of England |
| Occupation | Assembler |
| Address | Surry Hills, New South Wales |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs W Vertigans, 32 Marshall Street, Surry Hills, New South Wales |
| Enlistment date | 21 December 1916 |
| Rank on enlistment | Private |
| Unit name | 18th Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/35/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A18 Wiltshire on 7 February 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Employment Company |
| Fate | Returned to Australia 15 September 1918 |