| Regimental number | 11172 |
| Place of birth | East London South Africa |
| Religion | Church of England |
| Occupation | Motor driver |
| Address | Nambour, Queensland |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs A Wells, Bli Bli, Nambour, Queensland |
| Enlistment date | 13 September 1915 |
| Rank on enlistment | Gunner |
| Unit name | Field Artillery Brigade 3, Reinforcement 14 |
| AWM Embarkation Roll number | 13/31/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Osterley on 15 January 1916 |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | 2nd Field Artillery Brigade |
| Fate | Returned to Australia 19 February 1919 |
