| Regimental number | 6419 |
| Place of birth | Batlow New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | West Batlow, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Father, H G Cottam, Two Brooks, West Batlow |
| Enlistment date | 26 April 1916 |
| Rank on enlistment | Private |
| Unit name | 3rd Battalion, 20th Reinforcement |
| AWM Embarkation Roll number | 23/20/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A14 Euripides on 9 September 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Battalion |
| Fate | Returned to Australia 1 July 1919 |
