| Regimental number | 5076 |
| Place of birth | London England |
| Religion | Church of England |
| Occupation | Bushman |
| Address | 88 Australia Street, Newtown, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 40 |
| Next of kin | Sister, Mrs M Mortimer, 143 Lancashire Road, North Kensington London W, England |
| Enlistment date | 5 August 1915 |
| Rank on enlistment | Private |
| Unit name | 13th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/30/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A16 Star Of Victoria on 31 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 13th Battalion |
| Fate | Returned to Australia 7 June 1918 |