| Regimental number | 5420 |
| Place of birth | Lake Cargelligo New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Lake Cudgellico, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Father, S Norris, Bloomfield, Lake Cudgellico, New South Wales |
| Enlistment date | 17 December 1915 |
| Rank on enlistment | Private |
| Unit name | 2nd Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/19/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A4 Ceramic on 14 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 54th Battalion |
| Fate | Returned to Australia 8 May 1919 |
