| Regimental number | 5579 |
| Place of birth | Temora New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Bethungra, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Father, Burgess Douglas, Bethungra, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 18th Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/35/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A14 Euripides on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 18th Battalion |
| Fate | Died of wounds |
| Place of burial | Menin Road South Military Cemetery (Plot II, Row A1, Grave No. 23), Ypres, Belgium |
| Panel number, Roll of Honour, Australian War Memorial | 85 |
| Miscellaneous information from cemetery records | Town: Bethungra, New South Wales |
| Other details |
War service: Western Front Medals: British War Medal, Victory Medal |