| Regimental number | 6058 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Vaughan Street, Lidcombe, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Mrs Louisa Moore, Vaughan Street, Lidcombe, New South Wales |
| Enlistment date | 8 August 1916 |
| Date of enlistment from Nominal Roll | 3 August 1916 |
| Rank on enlistment | Private |
| Unit name | 22nd Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/39/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A8 Argyllshire on 31 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 22nd Battalion |
| Fate | Returned to Australia 7 July 1919 |
