| Regimental number | 17649 |
| Place of birth | Melbourne, Victoria |
| Religion | Church of England |
| Occupation | Barman |
| Address | Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 27 |
| Next of kin | Wife, Mrs Helen Louise Adams, 36 Prospect Street, Surry Hills, New South Wales |
| Enlistment date | 4 November 1916 |
| Rank on enlistment | Driver |
| Unit name | Sanitary Section 1, Engineer Reinforcements, March, 1917 |
| AWM Embarkation Roll number | 22/17/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A15 Port Sydney on 9 May 1917 |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | Signal Squadron |
| Fate | Returned to Australia 3 July 1919 |
