| Regimental number | 4676 |
| Place of birth | Newcastle New South Wales |
| Religion | Methodist |
| Occupation | Farmer |
| Address | Georgina, New South Wales |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Sister, Miss E Deane, c/o Mrs R Perkins, Cook Street, Lidcombe, New South Wales |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 20th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/37/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 20th Battalion |
| Recommendations (Medals and Awards) |
Military Medal Recommendation date: |
| Fate | Returned to Australia |