| Regimental number | 2164 |
| Place of birth | Grafton New South Wales |
| Religion | Roman Catholic |
| Occupation | Farmer |
| Address | Clarence Street, North Grafton, Clarence River, New South Wales |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Mother, Mrs Mary Jane Coulter, Clarence Street, North Grafton, New South Wales |
| Enlistment date | 5 October 1915 |
| Rank on enlistment | Private |
| Unit name | 5th Light Horse Regiment, 15th Reinforcement |
| AWM Embarkation Roll number | 10/10/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A67 Orsova on 11 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Battalion |
| Fate | Returned to Australia 21 May 1917 |