| Regimental number | 3904 |
| Place of birth | Southwark South Australia |
| Religion | Baptist |
| Occupation | Striker |
| Address | Southwark, South Australia |
| Marital status | Married |
| Age at embarkation | 26 |
| Next of kin | Wife, Mrs H I Sincock, 12 Cawthorne Street, Southwark, South Australia |
| Enlistment date | 1 May 1917 |
| Rank on enlistment | Private |
| Unit name | 5th Pioneer Battalion, Reinforcement 10 |
| AWM Embarkation Roll number | 14/17/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A60 Aeneas on 30 October 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Pioneer Battalion |
| Fate | Returned to Australia 5 July 1919 |
