| Regimental number | 2680 |
| Place of birth | Gympie, Queensland |
| Religion | Church of England |
| Occupation | Labourer |
| Address | William Street, Lutwyche, Brisbane, Queensland |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Sister, Mrs Agnes Hay, Wickham Street, Gympie, Queensland |
| Enlistment date | 20 September 1916 |
| Place of enlistment | Cairns, Queensland |
| Rank on enlistment | Private |
| Unit name | 42nd Battalion, 5th Reinforcement |
| AWM Embarkation Roll number | 23/59/2 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A55 Kyarra on 17 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 42nd Battalion |
| Fate | Returned to Australia 31 March 1919 |
| Sources | NAA: B2455, WADSWORTH Samuel |
