| Regimental number | 14963 |
| Place of birth | Newcastle New South Wales |
| Religion | Church of England |
| Occupation | Building contractor |
| Address | Newcastle, New South Wales |
| Marital status | Single |
| Age at embarkation | 29 |
| Next of kin | Mother, Mrs Sarah Cooke, Alpine, Southern Line, New South Wales |
| Enlistment date | 16 March 1916 |
| Rank on enlistment | Driver |
| Unit name | August 1916 Reinforcements |
| AWM Embarkation Roll number | 14/42/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A60 Aeneas on 30 September 1916 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 7th Field Company Engineers |
| Fate | Returned to Australia 2 March 1919 |