| Regimental number | 4121 |
| Place of birth | Murwillumbah New South Wales |
| Religion | Church of England |
| Occupation | Mechanic |
| Address | 6 Jubilee Street, Lewisham, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mother, Mrs F M Gray, 6 Jubilee Street, Lewisham, Sydney, New South Wales |
| Enlistment date | 12 August 1915 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/34/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A15 Star Of England on 8 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 17th Battalion |
| Fate | Returned to Australia 31 January 1918 |
