| Regimental number | 3934 |
| Place of birth | London England |
| Religion | Church of England |
| Occupation | Machinist |
| Address | Wentworth Road, Burwood, New South Wales |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs E Warn, Wentworth Road, Burwood, New South Wales |
| Enlistment date | 15 August 1915 |
| Rank on enlistment | Private |
| Unit name | 3rd Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/20/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 30 December 1915 |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 3rd Battalion |
| Fate | Returned to Australia 4 May 1917 |
