| Regimental number | 2121 |
| Religion | Church of England |
| Occupation | Horse-breaker |
| Address | Newbridge PO, Newbridge, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs Clara Ann Wilson, Newbridge PO, Newbridge, New South Wales |
| Enlistment date | 17 August 1915 |
| Rank on enlistment | Private |
| Unit name | 1st Light Horse Regiment, 14th Reinforcement |
| AWM Embarkation Roll number | 10/6/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT RMS Osterley on 15 January 1916 |
| Regimental number from Nominal Roll | Commissioned |
| Rank from Nominal Roll | Lieutenant |
| Unit from Nominal Roll | 15th Light Horse Regiment |
| Fate | Returned to Australia 28 May 1919 |