| Regimental number | 400 |
| Place of birth | Bothwell, Tasmania |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Bothwell, Tasmania |
| Marital status | Married |
| Age at embarkation | 26 |
| Next of kin | Wife, Mrs Laura Evans, 9 Fitzroy Street, St Kilda, Tasmania |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | PTE (AAMC) |
| Unit name | 12th Battalion, Headquarters |
| AWM Embarkation Roll number | 23/29/1 |
| Embarkation details | Unit embarked from Hobart, Tasmania, on board HMAT A2 Geelong on |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | 3rd Field Ambulance |
| Fate | Returned to Australia |
| Medals |
Military Medal Source: 'Commonwealth Gazette' No. 31 Date: |
| Date of death | |
| Place of burial | Cornelian Bay Crematorium |