| Regimental number | 4002 |
| Place of birth | Omaru New Zealand |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Cooma, New South Wales |
| Marital status | Married |
| Age at embarkation | 33 |
| Next of kin | Wife, Mrs. M. Cormack, Sharp Street, Cooma, New South Wales |
| Enlistment date | 24 August 1915 |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/21/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 30 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Pioneer Battalion |
| Fate | Returned to Australia 12 May 1919 |
