| Regimental number | 5749 |
| Place of birth | Mackay Queensland |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 55 Station Street, Port Melbourne, Victoria |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs J Rayment, 71 Hopper Street, Wellington, New Zealand |
| Enlistment date | 24 February 1916 |
| Rank on enlistment | Private |
| Unit name | 5th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/22/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A14 Euripides on 4 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Headquarters, AIF Depots in the United Kingdom |
| Fate | Returned to Australia 5 October 1919 |
