| Regimental number | 1004 |
| Place of birth | Ballarat Victoria |
| Religion | Roman Catholic |
| Occupation | Miner |
| Address | 1 Hope Street, West, Ballarat, Victoria |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Richard Waller, 1 Hope Street, Ballarat West, Victoria |
| Enlistment date | 18 August 1914 |
| Rank on enlistment | Private |
| Unit name | 1st Battalion, H Company |
| AWM Embarkation Roll number | 23/18/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board Transport A19 Afric on 18 October 1914 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Pioneer Battalion |
| Fate | Returned to Australia 4 May 1917 |
