| Regimental number | 1987 |
| Place of birth | Millthorpe New South Wales |
| Religion | Church of England |
| Occupation | Butcher |
| Address | Park Street, Milthorpe, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs Rebecca Sams, Park Street, Milthorpe, New South Wales |
| Enlistment date | 12 February 1916 |
| Rank on enlistment | Private |
| Unit name | 54th Battalion, 3rd Reinforcement |
| AWM Embarkation Roll number | 23/71/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A37 Barambah on 23 June 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 55th Battalion |
| Fate | Returned to Australia 10 April 1919 |
