| Regimental number | 6874A |
| Place of birth | Penshurst Victoria |
| Religion | Church of England |
| Occupation | Dairy Farmer |
| Address | Camperdown, Victoria |
| Marital status | Married |
| Age at embarkation | 39 |
| Next of kin | Wife, Mrs M W Phillips, Camperdown PO, Camperdown, Victoria |
| Enlistment date | 3 July 1917 |
| Rank on enlistment | Private |
| Unit name | 21st Battalion, 20th Reinforcement |
| AWM Embarkation Roll number | 23/38/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on 21 November 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 21st Battalion |
| Fate | Returned to Australia 20 November 1918 |
