| Regimental number | 5075 |
| Place of birth | Port Macquarie New South Wales |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Telegraph Point, Wilson River, New South Wales |
| Marital status | Single |
| Age at embarkation | 33 |
| Next of kin | Mother, Mrs S A Masters, Blackmans Point, Hastings River, New South Wales |
| Enlistment date | 3 January 1916 |
| Rank on enlistment | Private |
| Unit name | 3rd Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/20/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT SS Makarini on 1 April 1916 |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 3rd Battalion |
| Fate | Returned to Australia 31 May 1919 |
