| Regimental number | 4627 |
| Place of birth | Chelsea, England |
| Religion | Church of England |
| Occupation | Chauffeur |
| Address | Surrey, Byer Street, Enfield, New South Wales |
| Marital status | Married |
| Age at embarkation | 31 |
| Next of kin | Wife, Mrs Annie Ethel Wilson, Byer Street, Enfield, New South Wales |
| Enlistment date | 3 October 1916 |
| Place of enlistment | Sydney, New South Wales |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/47/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on 25 November 1916 |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 45th Battalion |
| Fate | Returned to Australia 5 April 1919 |
