| Regimental number | 3562 |
| Place of birth | Grafton New South Wales |
| Religion | Methodist |
| Occupation | Farmer |
| Address | Woombye, Queensland |
| Marital status | Married |
| Age at embarkation | 38 |
| Next of kin | Wife, Mrs Alice Avery, Woombye, Queensland |
| Enlistment date | 23 May 1916 |
| Rank on enlistment | Private |
| Unit name | 4th Pioneer Battalion, Reinforcement 9 |
| AWM Embarkation Roll number | 14/16/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A33 Ayrshire on 24 January 1917 |
| Regimental number from Nominal Roll | 3562A |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 9th Battalion |
| Fate | Returned to Australia 20 October 1918 |