| Regimental number | 21094 |
| Place of birth | Williamstown, Victoria |
| Religion | Presbyterian |
| Occupation | Salesman |
| Address | Caulfield, Victoria |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs Harriett Burgess, North Road, Caulfield, Victoria |
| Enlistment date | 10 September 1917 |
| Rank on enlistment | Sapper |
| Unit name | 1st to 5th Divisional Signal Companies and Signallers November 1917 Reinforcements |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on 28 February 1918 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | Australian General Base Depot |
| Fate | Effective abroad (still overseas) |
