| Regimental number | 6730 |
| Place of birth | Surrey England |
| Religion | Salvation Army |
| Occupation | Storeman |
| Address | North Fremantle, Western Australia |
| Marital status | Married |
| Age at embarkation | 29 |
| Next of kin | Wife, Mrs M Burtenshaw, Victoria Avenue, North Fremantle, Western Australia |
| Enlistment date | 9 June 1916 |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 22nd Reinforcement |
| AWM Embarkation Roll number | 23/28/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A8 Argyllshire on 9 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Battalion |
| Fate | Returned to Australia 25 August 1917 |
