| Regimental number | 2009 |
| Place of birth | Bathurst New South Wales |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Blackheath, New South Wales |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs Harriet S Cousins, Blackheath, New South Wales |
| Enlistment date | 6 October 1915 |
| Rank on enlistment | Private |
| Unit name | 7th Light Horse Regiment, 14th Reinforcement |
| AWM Embarkation Roll number | 10/12/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A57 Malakuta on 16 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 7th Light Horse Regiment |
| Fate | Returned to Australia 27 June 1919 |
