| Regimental number | 5241 |
| Place of birth | Sydney New South Wales |
| Religion | Congregational |
| Occupation | Carter |
| Address | 44 Raglan Street Manly, New South Wales |
| Marital status | Single |
| Age at embarkation | 32 |
| Next of kin | Mother, Mrs E Coates, 44 Raglan Street, Manly, New South Wales |
| Enlistment date | 28 August 1915 |
| Date of enlistment from Nominal Roll | 8 August 1915 |
| Rank on enlistment | Private |
| Unit name | 2nd Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/19/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A71 Nestor on 9 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 54th Battalion |
| Fate | Returned to Australia 31 January 1918 |
