| Regimental number | 5055 |
| Place of birth | Cape Barren Island, Tasmania |
| Religion | Church of England |
| Occupation | Farm labourer |
| Address | Cape Barren Ialand, Tasmania |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Father, Mr G H Burgess, Cape Barren Island, Tasmania |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 12th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/29/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Orontes on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 52nd Battalion |
| Fate | Returned to Australia |
| Date of death | |
| Place of burial | Carr Villa Cemetery |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
