| Regimental number | 5404 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 7 Kirk Lane, Ultimo, Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 30 |
| Next of kin | Wife, Mrs F L Masters, 7 Kirk Lane, Ultimo, Sydney, New South Wales |
| Enlistment date | 10 January 1916 |
| Rank on enlistment | Private |
| Unit name | 3rd Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/20/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on 14 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Battalion |
| Fate | Returned to Australia 31 May 1919 |
