| Regimental number | 1612 |
| Place of birth | Timpley England |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Brisbane, Queensland |
| Marital status | Married |
| Age at embarkation | 39 |
| Next of kin | Wife, Mrs Sarah Ann Burgess, Brisbane Street, Beaudesert, Queensland |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | December 1916 Reinforcements |
| AWM Embarkation Roll number | 11/14/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A42 Boorara on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Light Horse Regiment |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
