| Regimental number | 17634 |
| Place of birth | London England |
| Religion | Church of England |
| Occupation | Tiremaker |
| Address | 'Kenilworth', 260 Johnston Street, Annandale, New South Wales |
| Marital status | Married |
| Age at embarkation | 25 |
| Next of kin | Wife, Mrs. Margaret Alice Foreman, 234 Johnston Street, Annandale, New South Wales |
| Enlistment date | 11 September 1916 |
| Rank on enlistment | Sapper |
| Unit name | Divisional Signal Company 1, Reinforcement 27 |
| AWM Embarkation Roll number | 22/11/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A74 Marathon on 10 May 1917 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 1st Divisional Signal Company |
| Fate | Returned to Australia 31 July 1918 |
