| Regimental number | 1022 |
| Religion | Church of England |
| Occupation | Patternmaker |
| Marital status | Single |
| Age at embarkation | 35 |
| Next of kin | Mother, Mrs Emma Jane Davies, The Cottage, 210 Pershore Road, King's Norton, Birmingham, England |
| Enlistment date | 16 October 1916 |
| Rank on enlistment | Private |
| Unit name | Australian Flying Corps, No 4 Squadron, B Flight |
| AWM Embarkation Roll number | 8/7/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Omrah on 17 January 1917 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
