| Regimental number | 3012 |
| Place of birth | Liverpool England |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 67 Young Street, Annandale, New South Wales |
| Marital status | Married |
| Age at embarkation | 37 |
| Next of kin | Wife, Mrs Annie Shaw, 67 Young Street, Annandale, New South Wales |
| Enlistment date | 15 May 1916 |
| Date of enlistment from Nominal Roll | 16 May 1916 |
| Rank on enlistment | Private |
| Unit name | 54th Battalion, 7th Reinforcement |
| AWM Embarkation Roll number | 23/71/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A11 Ascanius on 25 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 54th Battalion |
| Fate | Returned to Australia 5 March 1919 |
