| Regimental number | 7029 |
| Place of birth | Nottingham England |
| Religion | Church of England |
| Occupation | Wheeler |
| Address | Kearsley via Cessnock, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, C Cook, Kearsley via Cessnock, New South Wales |
| Enlistment date | 20 July 1917 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/34/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A14 Euripides on 31 October 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 17th Battalion |
| Fate | Returned to Australia 9 November 1918 |