| Regimental number | 18629 |
| Place of birth | Newcastle New South Wales |
| Religion | Church of England |
| Occupation | Stevedore |
| Address | Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 41 |
| Next of kin | Wife, Mrs Esther Katie Ellis, Carlton House, 102 Victoria Street, Darlinghurst, New South Wales |
| Enlistment date | 18 February 1917 |
| Date of enlistment from Nominal Roll | 18 February 1917 |
| Rank on enlistment | Sapper |
| Unit name | May 1917 Reinforcements |
| AWM Embarkation Roll number | 14/42/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A68 Anchises on 8 August 1917 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | Engineers |
| Fate | Returned to Australia 21 April 1918 |
