| Regimental number | 3609 |
| Religion | Roman Catholic |
| Occupation | Hospital warder |
| Address | 56 Lonsdale Street, Melbourne, Victoria |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs W Fogarty, 656 Lonsdale Street, Melbourne, Victoria |
| Enlistment date | 3 June 1915 |
| Rank on enlistment | Private |
| Unit name | 12th Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/29/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A11 Ascanius on 10 November 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
