| Regimental number | 5373 |
| Place of birth | Adamstown New South Wales |
| Religion | Church of England |
| Occupation | Blacksmith |
| Address | New Norfolk, Tasmania |
| Marital status | Married |
| Age at embarkation | 30 |
| Next of kin | Wife, Mrs T C Adair, New Norfolk, Tasmania |
| Enlistment date | 4 June 1915 |
| Date of enlistment from Nominal Roll | 4 March 1915 |
| Rank on enlistment | Private |
| Unit name | Convalescent Depot, Harefield Park, London |
| AWM Embarkation Roll number | 26/84/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A67 Orsova on 17 July 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Australian Hospital Service |
| Fate | Returned to Australia 20 March 1917 |