| Regimental number | 3217 |
| Place of birth | Daylesford Vic |
| Religion | Church of England |
| Occupation | Milkman |
| Address | Boulder, Western Australia |
| Marital status | Married |
| Age at embarkation | 34 |
| Next of kin | Wife, Mrs Annie Haynes, Austral Street, Kalgoorlie, Western Australia |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | April 1917 Reinforcements |
| AWM Embarkation Roll number | 11/14/1 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A15 Port Sydney on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Army Camel Field Ambulance |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
