| Regimental number | 7129 |
| Place of birth | London England |
| Religion | Church of England |
| Occupation | Stewart |
| Address | Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Step-Father, John Impey, 82 Caulfield Street, Bethnal Green, London, England |
| Enlistment date | 3 January 1918 |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/36/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on 28 February 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 19th Battalion |
| Fate | Returned to Australia 12 December 1918 |
