| Regimental number | 17827 |
| Place of birth | London England |
| Religion | Church of England |
| Occupation | Barman |
| Address | Haberfield, New South Wales |
| Marital status | Married |
| Age at embarkation | 32 |
| Next of kin | Wife, Mrs E K Potter, Robertville Cottage, Northcote Street, Haberfield, New South Wales |
| Enlistment date | 19 July 1916 |
| Date of enlistment from Nominal Roll | 9 July 1916 |
| Rank on enlistment | Private |
| Unit name | May 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A68 Anchises on 8 August 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 7th Field Ambulance |
| Fate | Returned to Australia 7 July 1919 |
