| Regimental number | 2929 |
| Place of birth | The Oaks New South Wales |
| Religion | Church of England |
| Occupation | Hospital assistant |
| Address | Launceston, Tasmania |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs A Jordan, 55 Galvin Street, Launceston, Tasmania |
| Enlistment date | 23 July 1915 |
| Rank on enlistment | Private |
| Unit name | 12th Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 23/29/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A20 Hororata on 27 September 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 12th Battalion |
| Fate | Returned to Australia 12 April 1916 |
