| Regimental number | 16776 |
| Religion | Church of England |
| Occupation | Hairdresser |
| Address | Millicent, South Australia |
| Marital status | Married |
| Age at embarkation | 32 |
| Next of kin | Wife, Mrs W M Warner, Millicent, South Australia |
| Enlistment date | 10 May 1916 |
| Rank on enlistment | Private |
| Unit name | January 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A45 Bulla on 16 January 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 14th Australian General Hospital |
| Fate | Returned to Australia 2 August 1919 |