| Regimental number | 612 |
| Place of birth | Balmattum Victoria |
| Religion | Methodist |
| Occupation | Labourer |
| Address | Kyneton, Victoria |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs M Willis, Holbrook, New South Wales |
| Enlistment date | 23 October 1916 |
| Rank on enlistment | Private |
| Unit name | Machine Gun Company 2, Reinforcement 10 |
| AWM Embarkation Roll number | 24/7/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Omrah on 17 January 1917 |
| Regimental number from Nominal Roll | 612A |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Machine Gun Company |
| Fate | Returned to Australia 12 June 1919 |
