| Regimental number | 2804 |
| Religion | Church of England |
| Occupation | Cooper |
| Address | Nannup, Western Australia |
| Marital status | Married |
| Age at embarkation | 37 |
| Next of kin | Wife, Mrs Emily Coffey, Nannup, Western Australia |
| Enlistment date | 16 October 1916 |
| Date of enlistment from Nominal Roll | 27 September 1916 |
| Rank on enlistment | Private |
| Unit name | 44th Battalion, 6th Reinforcement |
| AWM Embarkation Roll number | 23/61/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A34 Persic on 29 December 1916 |
| Regimental number from Nominal Roll | 2804B |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 12th Battalion |
| Fate | Returned to Australia 16 December 1917 |
