| Regimental number | 21 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Carter |
| Address | Surry Hills, New South Wales |
| Marital status | Married |
| Age at embarkation | 27 |
| Next of kin | Wife, Mrs Alice Burridge, 12 Brisbane Street, Surry Hills, Sydney, New South Wales |
| Enlistment date | 3 April 1916 |
| Rank on enlistment | Private |
| Unit name | 3rd Divisional Cyclist Company |
| AWM Embarkation Roll number | 12/6/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A64 Demosthenes on 18 May 1916 |
