| Regimental number | 4272 |
| Place of birth | Mittagong New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Balgownie, South Coast, New South Wales |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Father, J Potter, Balgownie, South Coast, New South Wales |
| Enlistment date | 11 September 1915 |
| Rank on enlistment | Private |
| Unit name | 3rd Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/20/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A60 Aeneas on 20 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Battalion |
| Fate | Returned to Australia 3 July 1917 |
