| Regimental number | 6482 |
| Religion | Church of England |
| Occupation | Butcher |
| Address | 48 0 Sydney Road, Brunswick, Victoria |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs I Douglas, 480 Sydney Roadl, West Brunswick, Victoria |
| Enlistment date | 26 August 1916 |
| Date of enlistment from Nominal Roll | 28 August 1916 |
| Rank on enlistment | Private |
| Unit name | 6th Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/23/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on 2 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 6th Battalion |
| Fate | Returned to Australia 15 May 1919 |