| Regimental number | 4826 |
| Place of birth | Gulong New South Wales |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | High Street, Willoughby, Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 34 |
| Next of kin | Wife, Mrs Madge Derwin, High Street, Willoughby, Sydney, New Southy Wales |
| Enlistment date | 21 April 1917 |
| Rank on enlistment | Private |
| Unit name | 1st Pioneer Battalion, 14th Reinforcement |
| AWM Embarkation Roll number | 14/13/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A38 Ulysses on 19 December 1917 |