| Regimental number | 3964 |
| Place of birth | Mansfield Victoria |
| Religion | Roman Catholic |
| Occupation | Farmer |
| Address | Howes' Creek, Mansfield, Victoria |
| Marital status | Single |
| Age at embarkation | 33 |
| Next of kin | Mother, Mrs. C. Withers, Howes' Creek, Mansfield, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 8th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/25/4 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A40 Ceramic on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
| Miscellaneous information from cemetery records | Plaque in Victorian Garden of Remembrance |
| Date of death |