| Regimental number | 5786 |
| Place of birth | Sale Victoria |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Orbost, East Gippsland, Victoria |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mother, Mrs. L.A. Waller, Orbost, East Gippsland, Victoria |
| Enlistment date | 10 March 1916 |
| Rank on enlistment | Private |
| Unit name | 6th Battalion, 18th Reinforcement |
| AWM Embarkation Roll number | 23/23/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A33 Ayrshire on 3 July 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 59th Battalion |
| Fate | Returned to Australia 21 March 1919 |