| Regimental number | 1104A |
| Place of birth | Hobart, Tasmania |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Plenty, Tasmania |
| Marital status | Married |
| Age at embarkation | 28 |
| Next of kin | Wife, Mrs Elizabeth O Balmforth, 44 Collins Street, Hobart, Tasmania |
| Enlistment date | 7 June 1916 |
| Date of enlistment from Nominal Roll | 7 June 1916 |
| Rank on enlistment | Private |
| Unit name | 40th Battalion, D Company |
| AWM Embarkation Roll number | 23/57/1 |
| Embarkation details | Unit embarked from Hobart, Tasmania, on board HMAT A35 Berrima on 1 July 1916 |
| Regimental number from Nominal Roll | 1117 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 40th Battalion |
| Fate | Returned to Australia 30 January 1918 |
