| Regimental number | 2107 |
| Place of birth | West Tamworth New South Wales |
| Religion | Church of England |
| Occupation | Carter |
| Address | West Tamworth, New South Wales |
| Marital status | Single |
| Age at embarkation | 34 |
| Next of kin | Mother, Mrs Susan Hayne, Deane Street, West Tamworth, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | December 1916 Reinforcements |
| AWM Embarkation Roll number | 11/14/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Karmala on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Field Ambulance |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
