| Regimental number | 3010 |
| Place of birth | Taree New South Wales |
| Occupation | Labourer |
| Address | Manning River, New South Wales |
| Marital status | Single |
| Age at embarkation | 39 |
| Next of kin | Sister, Mrs Lena Single, Manning River, New South Wales |
| Enlistment date | 15 January 1917 |
| Rank on enlistment | Private |
| Unit name | 42nd Battalion, 7th Reinforcement |
| AWM Embarkation Roll number | 23/59/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A18 Wiltshire on 7 February 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 42nd Battalion |
| Fate | Returned to Australia 21 December 1917 |