| Regimental number | 4501 |
| Place of birth | Clipstone England |
| Religion | Baptist |
| Occupation | Labourer |
| Address | Sunnyside Coventry Road, Market Harbro, England |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs A E Owen c/o Mrs Prosser, 2 Boyce Street, Glebe Point, New South Wales |
| Enlistment date | 8 December 1915 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/34/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A71 Nestor on 9 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 53rd Battalion |
| Fate | Returned to Australia 18 January 1919 |
