| Regimental number | 7804 |
| Place of birth | Parkes New South Wales |
| Religion | Church of England |
| Occupation | Blacksmith |
| Address | Parkesborough, via Parkes, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Guardian, Mrs. . Leavery, Parkesborough, via Parkes, New South Wales |
| Enlistment date | 4 August 1917 |
| Rank on enlistment | Private |
| Unit name | 1st Battalion, 26th Reinforcement |
| AWM Embarkation Roll number | 23/18/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A38 Ulysses on 19 December 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Battalion |
| Fate | Returned to Australia 6 July 1919 |
