| Regimental number | 5963 |
| Place of birth | Lincoln England |
| Religion | Church of England |
| Occupation | Miner |
| Address | The Duchess, Queensland |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs J G Bushell, Ferguson Street, Gympie, Queensland |
| Enlistment date | 25 July 1916 |
| Rank on enlistment | Sapper |
| Unit name | Tunnelling Companies, December 1916 Reinforcements |
| AWM Embarkation Roll number | 16/15/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A38 Ulysses on 25 October 1916 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | Tunnelling Companies |
| Fate | Returned to Australia 30 January 1918 |
