| Regimental number | 5099 |
| Place of birth | Gulgong New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Reedy Creek, Gulgong, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | ..., C C Wade, Reedy Creek, Gulgong, New South Wales |
| Enlistment date | 28 October 1915 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/34/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A55 Kyarra on 5 June 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 9th Light Trench Mortar Battery |
| Fate | Returned to Australia 11 May 1919 |
