| Regimental number | 5074 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Driver |
| Address | 34 Cooper Street, Waterloo, New South Wales |
| Marital status | Married |
| Age at embarkation | 36 |
| Next of kin | Wife, Mrs A M Collins, 34 Cooper Street, Waterloo, New South Wales |
| Enlistment date | 9 January 1916 |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/21/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Makarini on 1 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Battalion |
| Fate | Returned to Australia 21 July 1918 |