| Regimental number | 695 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Cameron Street, Balmain, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Father, T Challis, Cameron Street, Balmain, Sydney, New South Wales |
| Enlistment date | 11 January 1917 |
| Rank on enlistment | Private |
| Unit name | Machine Gun Company 3, Reinforcement 12 |
| AWM Embarkation Roll number | 24/8/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A29 Suevic on 21 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Machine Gun Company |
| Fate | Returned to Australia 21 April 1918 |
