| Regimental number | 6450 |
| Place of birth | Penguin, Tasmania |
| Religion | Roman Catholic |
| Occupation | Seaman |
| Address | Pacific House, Oban Street, Hawksburn, Victoria |
| Marital status | Single |
| Age at embarkation | 33 |
| Next of kin | Father, Richard Burgess, Pacific House, Oban Street, Hawksburn, Victoria |
| Enlistment date | 3 November 1916 |
| Rank on enlistment | Private |
| Unit name | 24th Battalion, 18th Reinforcement |
| AWM Embarkation Roll number | 23/41/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A20 Hororata on 23 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 24th Battalion |
| Fate | Returned to Australia 10 April 1919 |
