| Regimental number | 4869 |
| Place of birth | San Remo Victoria |
| Religion | Church of England |
| Occupation | Bank clerk |
| Address | San Remo, Victoria |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, Mr H Potter, San Remo, Victoria |
| Enlistment date | 18 September 1915 |
| Rank on enlistment | Private |
| Unit name | 8th Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/25/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A18 Wiltshire on 7 March 1916 |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 58th Battalion |
| Fate | Returned to Australia 17 June 1918 |
