| Regimental number | 5087 |
| Place of birth | Mannum, South Australia |
| Religion | Methodist |
| Occupation | Motor worker |
| Address | 92 George Street, Thebarton, South Australia |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs E Douglas, 92 George Street, Thebarton, South Australia |
| Enlistment date | 18 December 1915 |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/27/4 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A9 Shropshire on 25 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 10th Battalion |
| Fate | Returned to Australia 10 April 1919 |
