| Regimental number | 1004 |
| Date of birth | 19 April 1896 |
| Place of birth | Maryborough, Victoria |
| Religion | Methodist |
| Occupation | Miner |
| Address | Waterloo PO via Beaufort, Victoria |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Mrs J Davis, Waterloo PO via Beaufort, Victoria |
| Enlistment date | 19 July 1915 |
| Rank on enlistment | Private |
| Unit name | 13th Light Horse Regiment, 4th Reinforcement |
| AWM Embarkation Roll number | 10/18/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A20 Hororata on 27 September 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
| Other details | War service: Egypt, Western Front |
