| Regimental number | 3910 |
| Place of birth | Tasmania |
| Religion | Church of England |
| Occupation | Contractor |
| Address | King Island, Tasmania |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mother, Mrs H E House, Currie Harbor, King Island, Tasmania |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 12th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/29/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT RMS Orontes on |
| Rank from Nominal Roll | Sergeant |
| Unit from Nominal Roll | 1st Pioneer Battalion |
| Recommendations (Medals and Awards) |
Distinguished Conduct Medal (awarded Military Medal) 'Marked coolness, gallantry and devotion to duty, also valuable railway construction work. (East of Ypres)' Recommendation date: |
| Fate | Returned to Australia |
| Medals |
Military Medal Source: 'Commonwealth Gazette' No. 95 Date: |