| Regimental number | 2176 |
| Place of birth | Percyville Queensland |
| Religion | Church of England |
| Occupation | Stockman |
| Address | c/o Mrs Isabella Fraser, Georgetown via Cairns, Queensland |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs Mary Isabella Fraser, Georgetown via Cairns, Queensland |
| Enlistment date | 3 September 1915 |
| Rank on enlistment | Private |
| Unit name | 5th Light Horse Regiment, 15th Reinforcement |
| AWM Embarkation Roll number | 10/10/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A67 Orsova on 11 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Flying Corps |
| Fate | Returned to Australia 4 March 1919 |
