| Regimental number | 16405 |
| Place of birth | Paddington New South Wales |
| Religion | Church of England |
| Occupation | Machinist |
| Address | Camperdown, New South Wales |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs J Ford, 12 The Avenue, Camperdown, New South Wales |
| Enlistment date | 23 March 1916 |
| Rank on enlistment | Private |
| Unit name | December 1916 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A67 Orsova on 2 December 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Army Casualty Clearing Station |
| Fate | Returned to Australia 6 September 1919 |