| Regimental number | 4055 |
| Place of birth | Yandilla Queensland |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | Railway Hotel, Charleville, Queensland |
| Marital status | Single |
| Age at embarkation | 43 |
| Next of kin | Sister, Mrs Kate Bellamy, Bell Street, Toowoomba, Queensland |
| Enlistment date | 27 June 1917 |
| Rank on enlistment | Private |
| Unit name | 4th Pioneer Battalion, Reinforcement 11 |
| AWM Embarkation Roll number | 14/16/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 1 August 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Pioneer Battalion |
| Fate | Returned to Australia 1 February 1918 |
