| Regimental number | 4355 |
| Place of birth | Boorowa New South Wales |
| Religion | Methodist |
| Occupation | Labourer |
| Address | Jerrara Creek, New South Wales |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs Ellen Elizabeth Cooke, Gunning, New South Wales |
| Enlistment date | 12 July 1916 |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/47/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT SS Port Napier on 17 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 45th Battalion |
| Fate | Returned to Australia 12 May 1918 |
