| Regimental number | 4776 |
| Place of birth | Dooki Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Windsor, Victoria |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs Ruby Coulson, State School Fitzroy Street, St Kilda, Victoria |
| Enlistment date | 5 January 1917 |
| Rank on enlistment | Private |
| Unit name | 29th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/46/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A29 Suevic on 21 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 38th Battalion |
| Fate | Returned to Australia 17 March 1919 |
