| Regimental number | 4010 |
| Place of birth | Allandale Victoria |
| Religion | Methodist |
| Occupation | Labourer |
| Address | 96 Oroga Street, Boulder City, Western Australia |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs E Wilson, 285 Railway Parade, Maylands, Western Australia |
| Enlistment date | 16 September 1915 |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/28/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board RMS Mongolia on 22 November 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Battalion |
| Fate | Returned to Australia 13 February 1917 |
