| Regimental number | 3749 |
| Place of birth | Quipolly New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Werris Creek, New South Wales |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs F Fletcher, Werris Creek, New South Wales |
| Enlistment date | 28 August 1915 |
| Date of enlistment from Nominal Roll | 10 August 1915 |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/21/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 30 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Battalion |
| Fate | Returned to Australia 17 March 1919 |
