| Regimental number | 5779 |
| Place of birth | Ermington New South Wales |
| Religion | No religion |
| Occupation | Labourer |
| Address | Ermington, Parramatta River, New South Wales |
| Marital status | Single |
| Age at embarkation | 29 |
| Next of kin | Father, W Willis, Ermington, Parramatta River, New South Wales |
| Enlistment date | 24 January 1916 |
| Rank on enlistment | Private |
| Unit name | 2nd Battalion, 18th Reinforcement |
| AWM Embarkation Roll number | 23/19/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A55 Kyarra on 3 June 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Battalion |
| Fate | Returned to Australia 31 May 1919 |