| Regimental number | 5902 |
| Place of birth | Calstock England |
| Religion | Church of England |
| Occupation | Miner |
| Address | Ravensthorpe, Western Australia |
| Marital status | Single |
| Age at embarkation | 43 |
| Next of kin | Sister, Miss Emma Stacey, Exeter, Devon, England |
| Enlistment date | 26 April 1915 |
| Rank on enlistment | Private |
| Unit name | 28th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/45/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A23 Suffolk on 13 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Veterinary Hospital |
| Fate | Returned to Australia 3 March 1919 |
