| Regimental number | 5658 |
| Place of birth | Balmain New South Wales |
| Religion | Methodist |
| Occupation | Labourer |
| Address | 162 Balmain Road, Leichhardt, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs E Blakeney, 162 Balmain Road, Leichhardt, Sydney, New South Wales |
| Enlistment date | 11 February 1916 |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 18th Reinforcement |
| AWM Embarkation Roll number | 23/21/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A55 Kyarra on 3 June 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Battalion |
| Fate | Returned to Australia 4 January 1919 |
