| Regimental number | 6155 |
| Place of birth | Cornwall England |
| Religion | Orthodox |
| Occupation | Fitter |
| Address | Workmans Home, Sussex Street, Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 39 |
| Next of kin | Mother, Mrs Jane Woods, Cross Road near Scorrier, Cornwell, England |
| Enlistment date | 5 August 1916 |
| Rank on enlistment | Private |
| Unit name | 21st Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/38/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A19 Afric on 3 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 21st Battalion |
| Fate | Returned to Australia 23 May 1917 |