| Regimental number | 4781 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Station Street, St. Marys, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Mrs W G Cook, Station Street, St Marys, New South Wales |
| Enlistment date | 21 September 1915 |
| Rank on enlistment | Private |
| Unit name | 3rd Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/20/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A15 Star Of England on 8 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Division Salvage Company |
| Fate | Returned to Australia 18 January 1919 |
