| Regimental number | 6780 |
| Place of birth | Narre Warren, Victoria |
| Religion | Methodist |
| Occupation | Labourer |
| Address | Narre Warren North, Victoria |
| Marital status | Single |
| Age at embarkation | 44 |
| Next of kin | Sister, Mrs Helena Smith, Narre Warren, North Victoria |
| Enlistment date | 18 January 1917 |
| Rank on enlistment | Private |
| Unit name | 23rd Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/40/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A11 Ascanius on 11 May 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 23rd Battalion |
| Fate | Returned to Australia 5 November 1917 |
