| Regimental number | 21047 |
| Place of birth | Eaglehawk Victoria |
| Religion | Church of England |
| Occupation | Traveller |
| Address | Boulder, Western Australia |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs Jane Grey, 28 Clancy Street, Boulder, Western Australia |
| Enlistment date | 19 December 1916 |
| Date of enlistment from Nominal Roll | 14 December 1916 |
| Rank on enlistment | Sapper |
| Unit name | 1st to 5th Divisional Signal Companies and Signallers November 1917 Reinforcements |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board SS Indarra on 26 November 1917 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 4th Divisional Signal Company |
| Fate | Returned to Australia 12 July 1919 |
