| Regimental number | 6504 |
| Place of birth | Claremont, Western Australia |
| Religion | Congregational |
| Occupation | Labourer |
| Address | Narra Tarra, Western Australia |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs A Davies, Wharfe Street, Queen's Park, Western Australia |
| Enlistment date | 19 June 1916 |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/28/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A23 Suffolk on 10 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Battalion |
| Fate | Returned to Australia 17 June 1918 |
