| Regimental number | 3001 |
| Place of birth | Blackbutt Queensland |
| Religion | Church of England |
| Occupation | Teamster |
| Address | Blackbutt, Queensland |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Father, J Douglass, Blackbutt, Queensland |
| Enlistment date | 3 October 1917 |
| Rank on enlistment | Private |
| Unit name | Queensland Reinforcement 2 |
| AWM Embarkation Roll number | 23/111/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Osterley on 8 May 1918 |
| Regimental number from Nominal Roll | 53001 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 41st Battalion |
| Fate | Returned to Australia 3 August 1919 |