| Regimental number | 3621 |
| Place of birth | Toowoomba Queensland |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Windsor, Queensland |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mother, Mrs Ellen Cobb, Newmarket Road, Windsor, Queensland |
| Enlistment date | 6 July 1917 |
| Rank on enlistment | Private |
| Unit name | 52nd Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/69/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A14 Euripides on 31 October 1917 |
| Regimental number from Nominal Roll | 3621A |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 49th Battalion |
| Fate | Returned to Australia 12 July 1919 |
