| Regimental number | 63 |
| Place of birth | Welshpool Wales |
| Religion | Church of England |
| Occupation | Locomotive fireman |
| Address | Goulburn, New South Wales |
| Marital status | Married |
| Age at embarkation | 25 |
| Next of kin | Wife, Mrs Mary Edwards, Clifford Street, Goulburn, New South Wales |
| Enlistment date | 21 December 1916 |
| Rank on enlistment | CSM (WO Class II) |
| Unit name | Section 1 |
| AWM Embarkation Roll number | 15/9/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A18 Wiltshire on 7 February 1917 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |