| Regimental number | 4684 |
| Place of birth | Williamstown, Victoria |
| Religion | Church of England |
| Occupation | Repairer |
| Address | 20 Errol Street, Footscray, Melbourne, Victoria |
| Marital status | Married |
| Age at embarkation | 42 |
| Next of kin | Wife, Mrs E J Cook, 20 Errol Street, Footscray, Melbourne, Victoria |
| Enlistment date | 16 February 1916 |
| Date of enlistment from Nominal Roll | 29 January 1916 |
| Rank on enlistment | Private |
| Unit name | 22nd Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/39/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A14 Euripides on 4 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 22nd Battalion |
| Fate | Returned to Australia 29 May 1919 |
