| Regimental number | 4099 |
| Place of birth | Arabia England |
| Religion | Church of England |
| Occupation | Miner |
| Address | Geraldton, Western Australia |
| Marital status | Single |
| Age at embarkation | 43 |
| Next of kin | Friend, Miss Nellie Sherry, 51 Cantonment Street, Fremantle, Western Australia |
| Enlistment date | 8 January 1916 |
| Rank on enlistment | Private |
| Unit name | 27th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/44/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board RMS Mongolia on 9 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Pioneer Battalion |
| Fate | Returned to Australia 22 July 1917 |
