| Regimental number | 6758 |
| Place of birth | Orange New South Wales |
| Religion | Roman Catholic |
| Occupation | Cook |
| Address | Lee Street, Wellington, New South Wales |
| Marital status | Single |
| Age at embarkation | 38 |
| Next of kin | Mother, Mrs C Ivers, 197 Victoria Street, Darlinghurst, New South Wales |
| Enlistment date | 26 July 1916 |
| Rank on enlistment | Private |
| Unit name | 13th Battalion, 22nd Reinforcement |
| AWM Embarkation Roll number | 23/30/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT Port Nicholson on 8 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 13th Battalion |
| Fate | Returned to Australia 27 September 1917 |
