| Regimental number | 4000 |
| Place of birth | Newcastle Western Australia |
| Religion | Salvation Army |
| Occupation | Grocer |
| Address | c/o T A Harrison, Northam, Western Australia |
| Marital status | Married |
| Age at embarkation | 34 |
| Next of kin | Wife, Mrs G Wells c/o T A Harrison, Fitzgerald Street, Northam, Western Australia |
| Enlistment date | 31 August 1915 |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/28/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board RMS Mongolia on 22 November 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Battalion |
| Fate | Returned to Australia 8 August 1918 |
