| Regimental number | 6764A |
| Place of birth | Bendigo, Victoria |
| Religion | Roman Catholic |
| Occupation | Chauffeur |
| Address | Bendigo, Victoria |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mother, Mrs M A Blake, 104 Violet Street, Bendigo, Victoria |
| Enlistment date | 16 July 1917 |
| Date of enlistment from Nominal Roll | 27 July 1917 |
| Rank on enlistment | Private |
| Unit name | 22nd Battalion, 20th Reinforcement |
| AWM Embarkation Roll number | 23/39/5 |
| 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 | 22nd Battalion |
| Fate | Returned to Australia 22 August 1919 |
