| Regimental number | 57758 |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Maitland, New South Wales |
| Marital status | Single |
| Age at embarkation | 29 |
| Next of kin | Cousin, Mrs E B Mark, Aberdare via Maitland, New South Wales |
| Enlistment date | 25 April 1918 |
| Rank on enlistment | Private |
| Unit name | Queensland Reinforcement 4 |
| AWM Embarkation Roll number | 23/111/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Orontes on 5 June 1918 |
| Regimental number from Nominal Roll | 57768 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 9th Battalion |
| Fate | Returned to Australia 4 December 1918 |
