| Regimental number | 3621 |
| Place of birth | Brisbane Queensland |
| Religion | Church of England |
| Occupation | French polisher |
| Address | Spring Hill, Brisbane, Queensland |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Friend, Mrs Annie Alice Smith, 35 Baitley St, Spring Hill, Brisbane, Queensland |
| Enlistment date | 22 June 1917 |
| Rank on enlistment | Private |
| Unit name | 49th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/66/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 1 August 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 49th Battalion |
| Fate | Returned to Australia 24 January 1919 |
