| Regimental number | 4975 |
| Place of birth | Melbourne, Victoria |
| Religion | Church of England |
| Occupation | Sawyer |
| Address | 123 Evans Street, East Brunswick, Victoria |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs Hannah Ansell, 23 Evans Street, East Brunswick, Melbourne, Victoria |
| Enlistment date | 14 February 1916 |
| Date of enlistment from Nominal Roll | 5 February 1916 |
| Rank on enlistment | Private |
| Unit name | 22nd Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/39/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A33 Ayrshire on 3 July 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 22nd Battalion |
| Fate | Returned to Australia 18 July 1919 |
