| Regimental number | 5781 |
| Place of birth | Merimbula New South Wales |
| Religion | Church of England |
| Occupation | Carriage painter |
| Address | Washington Street, Rockdale, New South Wales |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs Charlotte Amy, Washington Street, Rockdale, New South Wales |
| Enlistment date | 1 May 1916 |
| Date of enlistment from Nominal Roll | 1 May 1916 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/34/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on 7 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Employment Company |
| Fate | Returned to Australia 17 January 1919 |
