| Regimental number | 7116 |
| Place of birth | Old Junee New South Wales |
| Religion | Presbyterian |
| Occupation | Farmer |
| Address | Old Junee, New South Wales |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs E S Vivian, Old Junee, New South Wales |
| Enlistment date | 17 July 1917 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/34/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A14 Euripides on 31 October 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 17th Battalion |
| Fate | Returned to Australia 9 December 1918 |
