| Regimental number | 4916 |
| Place of birth | Grenfell New South Wales |
| Religion | Roman Catholic |
| Occupation | Jeweller |
| Address | Thompson Street, Canterbury, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Mrs E O'Connor, C/o H Jacobson, Thompson Street, Canterbury, New South Wales |
| Enlistment date | 6 September 1915 |
| Rank on enlistment | Private |
| Unit name | 1st Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/18/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A15 Star Of England on 8 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 53rd Battalion |
| Fate | Returned to Australia 4 January 1919 |
