| Regimental number | 5775 |
| Place of birth | Collingwood Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 45 Sydney Street, Collingwood, Victoria |
| Marital status | Married |
| Age at embarkation | 35 |
| Next of kin | Wife, Mrs F Wallace, 45 Sydney Street, Collingwood, Victoria |
| Enlistment date | 3 January 1916 |
| Date of enlistment from Nominal Roll | 13 January 1916 |
| Rank on enlistment | Private |
| Unit name | 5th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/22/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A14 Euripides on 4 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Battalion |
| Fate | Returned to Australia 20 December 1917 |