| Regimental number | 5667 |
| Place of birth | Sorrento Victoria |
| Religion | Church of England |
| Occupation | Cook |
| Address | 5 Station Street, Camberwell, Victoria |
| Marital status | Married |
| Age at embarkation | 28 |
| Next of kin | Wife, Mrs M Cousins, c/o Mrs Hubbard, 176 Unley Road, Unley, South Australia |
| Enlistment date | 20 March 1916 |
| Rank on enlistment | Private |
| Unit name | 7th Battalion, 18th Reinforcement |
| AWM Embarkation Roll number | 23/24/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A33 Ayrshire on 3 July 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 7th Battalion |
| Fate | Returned to Australia 12 May 1919 |
