| Regimental number | 4403 |
| Place of birth | Carroll New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Carroll via Gunnedah, New South Wales |
| Marital status | Single |
| Age at embarkation | 35 |
| Next of kin | Father, H Davies, Carroll via Gunnedah, New South Wales |
| Enlistment date | 3 January 1916 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/34/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A71 Nestor on 9 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 17th Battalion |
| Fate | Returned to Australia 29 May 1919 |
