| Regimental number | 1069 |
| Place of birth | Prospect South Australia |
| Religion | Church of England |
| Occupation | Washout man |
| Address | West Guildford, Western Australia |
| Marital status | Married |
| Age at embarkation | 40 |
| Next of kin | Wife, Mrs Sarah A C Warn, West Road, West Guildford, Western Australia |
| Enlistment date | 9 January 1917 |
| Date of enlistment from Nominal Roll | 8 January 1917 |
| Rank on enlistment | Private |
| Unit name | Railway Unit, Section 3 |
| AWM Embarkation Roll number | 15/9/1 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A28 Miltiades on 24 January 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Rly Sec |
| Fate | Returned to Australia 6 November 1918 |