| Regimental number | 1687 |
| Place of birth | Broken Hill New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 57 Robe Street, St Kilda, Victoria |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Mother, Mrs Annie Sophia Davis, Morgan Street, Broken Hill, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 2nd Pioneer Battalion, Reinforcement 2 |
| AWM Embarkation Roll number | 14/14/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A60 Aeneas on |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 2nd Pioneer Battalion |
| Recommendations (Medals and Awards) |
Military Medal Recommendation date: |
| Fate | Returned to Australia |
| Medals |
Military Medal Source: 'Commonwealth Gazette' No. 119 Date: |