| Regimental number | 6863 |
| Place of birth | Adelaide, South Australia |
| Religion | Church of England |
| Occupation | Butcher and Barman |
| Address | Adelaide, South Australia |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs L Bansemer, Cockatoo Valley, South Australia |
| Enlistment date | 9 October 1916 |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 22nd Reinforcement |
| AWM Embarkation Roll number | 23/27/4 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A19 Afric on 7 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 10th Battalion |
| Fate | Returned to Australia 1 May 1919 |
