| Regimental number | 3626 |
| Place of birth | Melbourne, Victoria |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Amey's Track, Foster, Victoria |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Mother, Mrs S Collister (parent of adopted child), Amey's Track, Foster, Victoria |
| Enlistment date | 5 December 1917 |
| Rank on enlistment | Private |
| Unit name | 57th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/74/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on 28 February 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | ACorpsHQ |
| Fate | Returned to Australia 13 July 1919 |
