| Regimental number | 6406 |
| Place of birth | Broadway England |
| Religion | Roman Catholic |
| Occupation | Station hand |
| Address | Coal Bar via Miles, Queensland |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs Edith Cotterell, Willersey Hill Farm, Broadway, Worcestershire, England |
| Enlistment date | 24 October 1916 |
| Rank on enlistment | Private |
| Unit name | 25th Battalion, 18th Reinforcement |
| AWM Embarkation Roll number | 23/42/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A64 Demosthenes on 23 December 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 25th Battalion |
| Fate | Returned to Australia 11 December 1918 |
