| Regimental number | 4919 |
| Place of birth | Kent England |
| Religion | Church of England |
| Occupation | Saw mill hand |
| Address | 282 Beaconsfield Parade, Middle Park, Victoria |
| Marital status | Married |
| Age at embarkation | 43 |
| Next of kin | Wife, Mrs C Stevens, Powelltown, via Yarra Junction, Victoria |
| Enlistment date | 18 September 1915 |
| Rank on enlistment | Private |
| Unit name | 6th Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/23/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A18 Wiltshire on 7 March 1916 |
| Rank from Nominal Roll | Sergeant |
| Unit from Nominal Roll | a PROV C |
| Fate | Returned to Australia 5 March 1919 |
