| Regimental number | 30804 |
| Place of birth | Launceston, Tasmania |
| Religion | Church of England |
| Occupation | Tailor |
| Address | 76 Galvin Street, Launceston, Tasmania |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs E H Chick, 76 Galvin Street, Launceston, Tasmania |
| Previous military service | 40th Battery Australian Field Artillery |
| Enlistment date | 28 September 1916 |
| Rank on enlistment | Driver |
| Unit name | Field Artillery Brigade 15, Reinforcement 8 |
| AWM Embarkation Roll number | 13/42/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A20 Hororata on 23 November 1916 |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 7th Field Artillery Brigade |
| Fate | Returned to Australia 1 July 1919 |
