| Regimental number | 6641 |
| Place of birth | Mandurama New South Wales |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Woodstock, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, C Willard, Woodstock, New South Wales |
| Enlistment date | 19 January 1917 |
| Date of enlistment from Nominal Roll | 17 January 1917 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/34/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A18 Wiltshire on 7 February 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 17th Battalion |
| Fate | Returned to Australia 8 November 1918 |
