| Regimental number | 1410 |
| Place of birth | Brisbane Queensland |
| Religion | Church of England |
| Occupation | Fireman |
| Address | Catherine Hill Bay, New South Wales |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs Annie Douthwaite, Catherine Hill Bay, New South Wales |
| Enlistment date | 18 December 1915 |
| Rank on enlistment | Private |
| Unit name | 36th Battalion, Headquarters |
| AWM Embarkation Roll number | 23/53/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on 13 May 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 36th Battalion |
| Fate | Returned to Australia 21 December 1917 |