| Regimental number | 13155 |
| Place of birth | Broken Hill New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Maylands, Western Australia |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs E J Stephens, Guildford Road, Belmont, Western Australia |
| Enlistment date | 24 January 1916 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Special Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A63 Karoola on 14 March 1916 |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 12th Field Ambulance |
| Fate | Returned to Australia 1 June 1919 |
