| Regimental number | 16122 |
| Place of birth | Pine Hill Queensland |
| Religion | Methodist |
| Occupation | Assistant mechanic |
| Address | Brisbane, Queensland |
| Marital status | Married |
| Age at embarkation | 32 |
| Next of kin | Wife, Mrs Lily Chamberlain, Craigie Lea, Kelven Grove Road, Brisbane, Queensland |
| Enlistment date | 26 October 1916 |
| Rank on enlistment | Sapper |
| Unit name | November 1916 Reinforcements |
| AWM Embarkation Roll number | 14/42/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A29 Suevic on 16 December 1916 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 11th Field Company Engineers |
| Fate | Returned to Australia 24 August 1918 |
