| Regimental number | 2073 |
| Place of birth | Meckering Western Australia |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Mackering |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs Elizabeth Jane Shaw, 222 Beaufort Street, Perth, Western Australia |
| Enlistment date | 15 September 1915 |
| Rank on enlistment | Private |
| Unit name | 10th Light Horse Regiment, 14th Reinforcement |
| AWM Embarkation Roll number | 10/15/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A69 Warilda on 16 February 1916 |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 4th Division Ammunition Column |
| Fate | Returned to Australia 1 June 1919 |
