| Regimental number | 641 |
| Place of birth | Kadina South Australia |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Kensington, SA |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs Scerina Coulter, Shipster's Road, Kensington, South Australia |
| Enlistment date | 18 February 1916 |
| Rank on enlistment | Private |
| Unit name | 43rd Battalion, 2nd Reinforcement |
| AWM Embarkation Roll number | 23/60/2 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A70 Ballarat on 12 August 1916 |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 43rd Battalion |
| Fate | Returned to Australia 8 January 1919 |
