| Regimental number | 4134 |
| Place of birth | Goulburn New South Wales |
| Religion | Methodist |
| Occupation | Labourer |
| Address | Middle Arm Road, Goulburn, New South Wales |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Father, W. Burgess, The Forest Middle Arm Road, Goulburn, New South Wales |
| Enlistment date | 16 August 1915 |
| Rank on enlistment | Private |
| Unit name | 3rd Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/20/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A60 Aeneas on 20 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 45th Battalion |
| Fate | Returned to Australia 20 December 1918 |