| Regimental number | 2478 |
| Place of birth | Weston Supermare England |
| Religion | Baptist |
| Occupation | Labourer |
| Address | 39 Day Street, Marrickville, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 40 |
| Next of kin | Sister, Mrs K E Ford, Camphill, Forbes, New South Wales |
| Enlistment date | 2 August 1915 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 5th Reinforcement |
| AWM Embarkation Roll number | 23/34/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A32 Themistocles on 5 October 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Australian Dermatological Hospital |
| Fate | Returned to Australia 19 October 1917 |
