| Regimental number | 3976 |
| Place of birth | Rockhampton Queensland |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 369 Bolsover Street, Rockhampton, Queensland |
| Marital status | Single |
| Age at embarkation | 37 |
| Next of kin | Mother, Mrs M Carlos, 369 Bolsover Street, Rockhampton, Queensland |
| Enlistment date | 21 August 1915 |
| Rank on enlistment | Private |
| Unit name | 9th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/26/3 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A50 Itonus on 30 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 49th Battalion |
| Fate | Returned to Australia 31 January 1918 |
