| Regimental number | 11128 |
| Place of birth | Fitzroy, Victoria |
| Religion | Presbyterian |
| Occupation | Clerk |
| Address | 'Ercildoune', Brennand Street, North Fitzroy, Victoria |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Father, W H Douglass, 'Ercildoune', Brennand Street, North Fitzroy, Victoria |
| Enlistment date | 6 November 1915 |
| Rank on enlistment | Lance Corporal |
| Unit name | Divisional Ammunition Column 3, AMC |
| AWM Embarkation Roll number | 25/91/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A62 Wandilla on 6 June 1916 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A37 Barambah on 27 June 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 10th Field Ambulance |
| Fate | Returned to Australia 5 July 1919 |
