| Regimental number | 6504 |
| Place of birth | Glen Osmond, South Australia |
| Religion | Church of England |
| Occupation | Contractor |
| Address | Mitcham, South Australia |
| Marital status | Single |
| Age at embarkation | 35 |
| Next of kin | Mother, Mrs G S Ellison, Arnold Street, Mitcham, South Australia |
| Enlistment date | 14 August 1916 |
| Date of enlistment from Nominal Roll | 14 August 1916 |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/27/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A16 Port Melbourne on 21 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 10th Battalion |
| Fate | Returned to Australia 27 September 1917 |
