| Regimental number | 4622 |
| Place of birth | Sydney New South Wales |
| Religion | Roman Catholic |
| Occupation | Carter |
| Address | 71 Bank Street, North Sydney, New South Wales |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs M Annan, 71 Bank Street, North Sydney, New South Wales |
| Enlistment date | 9 September 1915 |
| Rank on enlistment | Private |
| Unit name | 3rd Battalion, 14th Reinforcement |
| AWM Embarkation Roll number | 23/20/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Osterley on 15 January 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Battalion |
| Fate | Returned to Australia 12 April 1916 |
