| Regimental number | 926 |
| Place of birth | Brisbane Queensland |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 5th Light Horse Regiment, 19th Reinforcement |
| AWM Embarkation Roll number | 10/10/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Mongolia on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Army Provost Corps |
| Fate | Returned to Australia |
| Date of death | |
| Place of burial | Albany Creek Crematorium |