| Regimental number | 15870 |
| Place of birth | Bedford England |
| Religion | Church of England |
| Occupation | Shop assistant |
| Address | Richmond, Victoria |
| Marital status | Married |
| Age at embarkation | 30 |
| Next of kin | Wife, Mrs A J Burnage, 12 Stawell Street, Richmond, Victoria |
| Enlistment date | 20 December 1915 |
| Date of enlistment from Nominal Roll | 4 December 1915 |
| Rank on enlistment | Private |
| Unit name | October 1916 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Port Napier on 17 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 10th Field Ambulance |
| Fate | Returned to Australia 24 January 1919 |
