| Regimental number | 50621 |
| Place of birth | Gympie Queensland |
| Religion | Methodist |
| Occupation | Grocer |
| Address | Alice Street, Silkstone, Ipswich, Queensland |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Father, D Davies, Alice Street, Silkstone, Ipswich, Queensland |
| Enlistment date | 18 January 1918 |
| Date of enlistment from Nominal Roll | 17 January 1918 |
| Rank on enlistment | Private |
| Unit name | Queensland Reinforcement 1 |
| AWM Embarkation Roll number | 23/111/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Osterley on 8 May 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 41st Battalion |
| Fate | Returned to Australia 3 July 1918 |
