| Regimental number | 5562 |
| Place of birth | Clapham England |
| Religion | Church of England |
| Occupation | Commercial traveller |
| Address | 42 Victoria Road, Manly, New South Wales |
| Marital status | Married |
| Age at embarkation | 35 |
| Next of kin | Wife, Mrs Mary Dackombe, 42 Victoria Road, Manly, New South Wales |
| Enlistment date | 1 February 1916 |
| Date of enlistment from Nominal Roll | 5 January 1916 |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/36/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A14 Euripides on 9 September 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Mechanical Transport Section |
| Fate | Returned to Australia 17 March 1919 |
