| Regimental number | 11186 |
| Place of birth | Hawthorn Victoria |
| Religion | Methodist |
| Occupation | Farm hand |
| Address | Northam, Western Australia |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Father, R Wallis, Ballidu, via Wongan Hill, Western Australia |
| Enlistment date | 1 February 1916 |
| Rank on enlistment | Private |
| Unit name | May 1916 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A52 Surada on 16 May 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Field Ambulance |
| Fate | Returned to Australia 1 June 1919 |
