| Regimental number | 5640 |
| Place of birth | Melbourne Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Western Road, Rozelle, New South Wales |
| Marital status | Single |
| Age at embarkation | 36 |
| Next of kin | Sister, Mrs Elizabeth Weeks, 1 Western Road, Rozelle, New South Wales |
| Enlistment date | 28 March 1916 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/34/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A14 Euripides on 9 September 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 17th Battalion |
| Fate | Returned to Australia 25 August 1917 |
