| Regimental number | 3356 |
| Place of birth | Perth, Western Australia |
| Religion | Protestant |
| Occupation | Labourer |
| Address | 97 Edward Street, East Perth, Western Australia |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Father, E T J Burgess, 97 Edward Street, East Perth, Western Australia |
| Enlistment date | 4 August 1915 |
| Rank on enlistment | Private |
| Unit name | 12th Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/29/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A24 Benalla on 1 November 1915 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 4th Divisional Signal Company |
| Fate | Returned to Australia 31 January 1918 |
