| Regimental number | 19365 |
| Religion | Church of England |
| Occupation | Mechanic |
| Address | Annandale, New South Wales |
| Marital status | Widower |
| Age at embarkation | 41 |
| Next of kin | Daughter, Una and Doris Derrin, 35 Johnstone Street, Annandale, New South Wales |
| Enlistment date | 16 May 1917 |
| Date of enlistment from Nominal Roll | 8 May 1917 |
| Rank on enlistment | Sapper |
| Unit name | Special Draft Reinforcements Signal Service (Egypt) |
| AWM Embarkation Roll number | 22/37/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A55 Kyarra on 3 September 1917 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 1st Signal Troop |
| Fate | Returned to Australia 16 March 1919 |
