| Regimental number | 7569 |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Longreach, Queensland |
| Marital status | Single |
| Age at embarkation | 42 |
| Next of kin | Sister, Mrs M I Smith, Wunulla via Kilcoy, Queensland |
| Enlistment date | 26 April 1916 |
| Rank on enlistment | Private |
| Unit name | 9th Battalion, 25th Reinforcement |
| AWM Embarkation Roll number | 23/26/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A20 Hororata on 14 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 9th Battalion |
| Fate | Returned to Australia 1 November 1917 |
