| Regimental number | 6067 |
| Place of birth | Pyrmont New South Wales |
| Religion | Church of England |
| Occupation | Bushman |
| Address | Post 0ffice, Northam, Western Australia |
| Marital status | Single |
| Age at embarkation | 39 |
| Next of kin | Cousin, Mr H W Periera, 163 Edward Street, East Perth, Western Australia |
| Enlistment date | 28 March 1916 |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/28/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A28 Miltiades on 7 August 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Battalion |
| Fate | Returned to Australia 1 June 1919 |
