| Regimental number | 11021 |
| Place of birth | Fitzroy Victoria |
| Religion | Methodist |
| Occupation | Coffee roaster |
| Address | 5 Forbes Street, Essendon, Victoria |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs Elizabeth Fouracre, 5 Forbes Street, Essendon, Victoria |
| Previous military service | 27th Signal Company Army Engineers |
| Enlistment date | 7 February 1916 |
| Rank on enlistment | Sapper |
| Unit name | Divisional Signal Company 3, Reinforcement 1 |
| AWM Embarkation Roll number | 22/13/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A11 Ascanius on 27 May 1916 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 3rd Divisional Signal Company |
| Fate | Returned to Australia 8 September 1919 |
