| Regimental number | 6654 |
| Place of birth | Bloemfontein South Africa |
| Religion | Roman Catholic |
| Occupation | Cook |
| Address | Southern Cross, Western Australia |
| Marital status | Single |
| Age at embarkation | 38 |
| Enlistment date | 28 April 1916 |
| Date of enlistment from Nominal Roll | 21 December 1916 |
| Rank on enlistment | Private |
| Unit name | 28th Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/45/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A28 Miltiades on 29 January 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 28th Battalion |
| Fate | Returned to Australia 25 September 1919 |