| Regimental number | 564 |
| Place of birth | Roma Queensland |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | Roma, Queensland |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mother, Mrs Maggie Sheppard, Jackson, West Line, Queensland |
| Enlistment date | 28 July 1916 |
| Rank on enlistment | Private |
| Unit name | Machine Gun Company 13, Reinforcement 9 |
| AWM Embarkation Roll number | 24/18/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Orontes on 23 December 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Machine Gun Battalion |
| Fate | Returned to Australia 12 December 1918 |
