| Regimental number | 4212 |
| Place of birth | Peckham England |
| Religion | Church of England |
| Occupation | Leather |
| Address | S |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Mrs Fountain, 43 Atwell Street, Rye Lane, Peckham London, England |
| Enlistment date | 7 August 1915 |
| Rank on enlistment | Private |
| Unit name | 8th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/25/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A64 Demosthenes on 29 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 8th Battalion |
| Fate | Returned to Australia 21 December 1917 |