| Regimental number | 4248 |
| Place of birth | Rockhampton Queensland |
| Religion | Church of England |
| Occupation | Dairy farmer |
| Address | Dapto, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Mrs Ann Cooper, Dapto, New South Wales |
| Previous military service | 37th Infantry |
| Enlistment date | 3 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 SS Port Nicholson on 8 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 30th Battalion |
| Fate | Returned to Australia 22 December 1918 |