| Regimental number | 5360 |
| Place of birth | Sutherland New South Wales |
| Religion | Roman Catholic |
| Occupation | Bricklayer |
| Address | President Avenue, Sutherland, Via, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Father, H Derrey, President Avenue, Sutherland, via Sydney, New South Wales |
| Enlistment date | 3 January 1916 |
| Date of enlistment from Nominal Roll | 19 January 1916 |
| Rank on enlistment | Private |
| Unit name | 3rd Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/20/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on 14 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Machine Gun Battalion |
| Fate | Returned to Australia 15 May 1919 |
