| Regimental number | 4172 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Motor mechanic |
| Address | Rockhampton, Queensland |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Father, H R Chivers, Barcaldine, Queensland |
| Enlistment date | 24 September 1915 |
| Rank on enlistment | Private |
| Unit name | 9th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/26/4 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A55 Kyarra on 3 January 1916 |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | Australian Army Service Corps Motor Transport |
| Fate | Returned to Australia 9 December 1918 |
