| Regimental number | 6365 |
| Place of birth | London England |
| Religion | Church of England |
| Occupation | Fireman |
| Address | Main Road, Russell Vale Bellambi, New South Wales |
| Marital status | Married |
| Age at embarkation | 35 |
| Next of kin | Wife, Mrs E M Shaw, Main Road, Russell Vale Bellambi, New South Wales |
| Enlistment date | 24 March 1916 |
| Rank on enlistment | Private |
| Unit name | 13th Battalion, 20th Reinforcement |
| AWM Embarkation Roll number | 23/30/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A14 Euripides on 9 September 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 13th Battalion |
| Fate | Returned to Australia 8 May 1919 |
