| Regimental number | 5058 |
| Place of birth | Accrington England |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 515 Kent Street, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Sister, Mrs H Hill, 14 Rippon Road, Oswald, Twiston, Lancashire, England |
| Enlistment date | 6 December 1915 |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/36/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A31 Ajana on 5 July 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 33rd Battalion |
| Fate | Returned to Australia 11 May 1919 |
