| Regimental number | 3374 |
| Place of birth | India |
| Religion | Church of England |
| Occupation | Hospital attendant |
| Address | Ballarat, Victoria |
| Marital status | Married |
| Age at embarkation | 41 |
| Next of kin | Wife, Mrs Sophia Cooper, 106 Clyde Street, Ballarat, Victoria |
| Enlistment date | 20 March 1917 |
| Rank on enlistment | Private |
| Unit name | 57th Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 23/74/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A29 Suevic on 21 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 57th Battalion |
| Fate | Returned to Australia 25 September 1919 |
