| Regimental number | 1664 |
| Place of birth | Sunny Corner New South Wales |
| Religion | Church of England |
| Occupation | Miner |
| Address | Forrest Street, Collie, Western Australia |
| Marital status | Single |
| Age at embarkation | 26 |
| Next of kin | Mother, Mrs Isabella Annesley, Forrest Street, Collie, Western Australia |
| Enlistment date | 16 June 1915 |
| Rank on enlistment | Private |
| Unit name | 28th Battalion, 2nd Reinforcement |
| AWM Embarkation Roll number | 23/45/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A64 Demosthenes on 23 July 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 28th Battalion |
| Fate | Returned to Australia 4 May 1917 |