| Regimental number | 3695 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Carter |
| Address | Tempe, New South Wales |
| Marital status | Married |
| Age at embarkation | 25 |
| Next of kin | Wife, Mrs Myrtle Beatrice Cook, Little Moss, Rocky Point Road, Arncliffe, New South Wales |
| Enlistment date | 1 August 1917 |
| Rank on enlistment | Private |
| Unit name | 55th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/72/5 |
| 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 | 1st Battalion |
| Fate | Returned to Australia 13 December 1918 |