| Regimental number | 4570 |
| Place of birth | Homebush New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | George Street, Homebush, New South Wales |
| Marital status | Married |
| Age at embarkation | 30 |
| Next of kin | Mother, Mrs Wootton, George Street, Homebush, New South Wales |
| Enlistment date | 4 January 1916 |
| Date of enlistment from Nominal Roll | 16 December 1915 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/34/2 |
| 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 | 17th Battalion |
| Fate | Returned to Australia 20 May 1919 |
