| Regimental number | 3862 |
| Place of birth | Ilford England |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 49 Wickham Street, East Perth, Western Australia |
| Marital status | Married |
| Age at embarkation | 41 |
| Next of kin | Wife, Mrs M Burgess, 49 Wickham Street, East Perth, Western Australia |
| Enlistment date | 21 August 1915 |
| Date of enlistment from Nominal Roll | 18 August 1915 |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/33/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A31 Ajana on 22 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 16th Battalion |
| Fate | Returned to Australia 3 March 1919 |
