| Regimental number | 5563 |
| Place of birth | Geelong, Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Gordonvale via Cairns, Queensland |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs Margaret Cook, 53 Church Street, Albert Park, Melbourne, Victoria |
| Enlistment date | 29 April 1916 |
| Rank on enlistment | Private |
| Unit name | 26th Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/43/4 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A46 Clan Macgillivray on 7 September 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 26th Battalion |
| Fate | Returned to Australia 15 April 1918 |
