| Regimental number | 54065 |
| Place of birth | Berrigan New South Wales |
| Religion | Church of England |
| Occupation | Leather dresser |
| Address | West Wyalong, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, F Cottle, Church Street, West Wyalong, New South Wales |
| Enlistment date | 1 May 1918 |
| Date of enlistment from Nominal Roll | 18 April 1918 |
| Rank on enlistment | Private |
| Unit name | New South Wales Reinforcement 5 |
| AWM Embarkation Roll number | 23/111/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Feldmarschall on 19 June 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Base Depot |
| Fate | Returned to Australia 5 September 1919 |
