| Regimental number | 5684 |
| Place of birth | Brighton, Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 15 Vine Street, North Perth, Western Australia |
| Marital status | Married |
| Age at embarkation | 29 |
| Next of kin | Wife, Mrs Agnes Burgess, 15 Vine Street, North Perth, Western Australia |
| Enlistment date | 21 March 1916 |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, 18th Reinforcement |
| AWM Embarkation Roll number | 23/33/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A48 Seang Bee on 18 July 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 16th Battalion |
| Fate | Returned to Australia 3 March 1919 |
