| Regimental number | 9121 |
| Place of birth | London England |
| Religion | Church of England |
| Occupation | Accountant |
| Address | Anglesley, Forbes, New South Wales |
| Marital status | Married |
| Age at embarkation | 40 |
| Next of kin | Wife, Mrs Edith Burr, Annesley, Forbes, New South Wales |
| Enlistment date | 7 January 1915 |
| Rank on enlistment | Staff Sergeant |
| Unit name | Dermatological Hospital |
| AWM Embarkation Roll number | 26/69/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A61 Kanowna on 22 December 1915 |
| Rank from Nominal Roll | Staff Sergeant |
| Unit from Nominal Roll | 5th Field Ambulance |
| Fate | Returned to Australia 1 February 1918 |
