| Regimental number | 16179 |
| Place of birth | Orange New South Wales |
| Religion | Methodist |
| Occupation | Carpenter |
| Address | Waverley, New South Wales |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs Helena Booth Brook, 'Heathcote', Cross Street, Waverley, New South Wales |
| Enlistment date | 22 February 1916 |
| Date of enlistment from Nominal Roll | 11 February 1916 |
| Rank on enlistment | Sapper |
| Unit name | November 1916 Reinforcements |
| AWM Embarkation Roll number | 14/42/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A29 Suevic on 11 November 1916 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 2nd Field Company Engineers |
| Fate | Returned to Australia 31 March 1919 |
