| Regimental number | 3500 |
| Place of birth | Marulan New South Wales |
| Religion | Church of England |
| Occupation | Grazier |
| Address | Oberon, New South Wales |
| Marital status | Married |
| Age at embarkation | 39 |
| Next of kin | Wife, Mrs Eva Hazelgrove Burcher, Oberon, New South Wales |
| Enlistment date | 24 October 1916 |
| Rank on enlistment | Private |
| Unit name | 54th Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 23/71/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A68 Anchises on 24 January 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Division Motor Transport Company |
| Fate | Returned to Australia 25 March 1919 |
