| Regimental number | 5462 |
| Place of birth | Bourke New South Wales |
| Religion | Church of England |
| Occupation | Navvy |
| Address | 38 Meagher Street, Chippendale, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Father, L Surrey, Bourke, New South Wales |
| Enlistment date | 5 January 1916 |
| Rank on enlistment | Private |
| Unit name | 13th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/30/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A71 Nestor on 9 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 13th Battalion |
| Fate | Returned to Australia 15 April 1918 |
