| Regimental number | 30167 |
| Place of birth | Melbourne, Victoria |
| Religion | Church of England |
| Occupation | Commercial traveller |
| Address | 8 Bucklands Avenue, Geelong, Victoria |
| Marital status | Married |
| Age at embarkation | 32 |
| Next of kin | Wife, Mrs A Belot, 8 Bucklands Avenue, Geelong, Victoria |
| Enlistment date | 9 September 1916 |
| Rank on enlistment | Gunner |
| Unit name | Field Artillery Brigade 1, Reinforcement 22 |
| AWM Embarkation Roll number | 13/29/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A24 Benalla on 9 November 1916 |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 3rd Divisional Ammunition Column |
| Fate | Returned to Australia 30 January 1918 |
