| Regimental number | 16653 |
| Place of birth | Stroud New South Wales |
| Religion | Church of England |
| Occupation | Blacksmith's striker |
| Address | Randwick, New South Wales |
| Marital status | Divorced |
| Age at embarkation | 42 |
| Next of kin | Sister, Mrs S Small, Narrabri, New South Wales |
| Enlistment date | 13 June 1916 |
| Date of enlistment from Nominal Roll | 14 February 1916 |
| Rank on enlistment | Private |
| Unit name | January 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Osterley on 10 February 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Returned to Australia 9 August 1919 |
