| Regimental number | 5122 |
| Place of birth | Spring Hill Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 179 Albion Street, West Brunswick, Vic, |
| Marital status | Single |
| Age at embarkation | 40 |
| Next of kin | Sister, Mrs Todd, 179 Albion Street, West Brunswick, Melbourne, Victoria |
| Enlistment date | 28 December 1915 |
| Rank on enlistment | Private |
| Unit name | 22nd Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/39/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A33 Ayrshire on 3 July 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 22nd Battalion |
| Fate | Returned to Australia 29 May 1919 |