| Regimental number | 709 |
| Place of birth | Kilkenny, South Australia |
| Religion | Methodist |
| Occupation | Horse driver |
| Address | Hodgman Road, Pennington, South Australia |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs E M Douglas, Hodgman Road, Pennington, South Australia |
| Previous military service | 10th AGA |
| Enlistment date | |
| Rank on enlistment | Gunner |
| Unit name | Heavy Artillery Group 36, Reinforcement 6 |
| AWM Embarkation Roll number | 13/49/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on |
| Rank from Nominal Roll | Gunner |
| Unit from Nominal Roll | 36th Heavy Artillery Brigade |
| Recommendations (Medals and Awards) |
Military Medal Recommendation date: |
| Fate | Returned to Australia |