| Regimental number | 210 |
| Place of birth | Launceston, Tasmania |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 73 Frankland Street, Launceston, Tasmania |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs H Champ, 73 Frankland Street, Launceston, Tasmania |
| Enlistment date | 26 August 1914 |
| Rank on enlistment | Private |
| Unit name | 12th Battalion, B Company |
| AWM Embarkation Roll number | 23/29/1 |
| Embarkation details | Unit embarked from Hobart, Tasmania, on board Transport A2 Geelong on 20 October 1914 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 12th Battalion |
| Fate | Returned to Australia 21 March 1915 |
