| Regimental number | 5691 |
| Place of birth | Brisbane Qld |
| Religion | Church of England |
| Occupation | Butter packer |
| Address | Caboolture PO, Caboolture, NC Line, Queensland |
| Marital status | Single |
| Age at embarkation | 26 |
| Next of kin | Mother, Mrs R Haworth, Caboolture, NC Line, Queensland |
| Enlistment date | 13 January 1916 |
| Rank on enlistment | Private |
| Unit name | 15th Battalion, 18th Reinforcement |
| AWM Embarkation Roll number | 23/32/2 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A49 Seang Choon on 4 May 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 15th Battalion |
| Fate | Returned to Australia 3 July 1917 |
