| Regimental number | 277 |
| Place of birth | Shellharbour New South Wales |
| Religion | Roman Catholic |
| Occupation | Farmer |
| Address | Federal PO, Richmond River, New South Wales |
| Marital status | Single |
| Age at embarkation | 26 |
| Next of kin | Father, R Fuller, Federal PO, Richmond River, New South Wales |
| Enlistment date | 20 October 1914 |
| Rank on enlistment | Private |
| Unit name | 5th Light Horse Regiment, B Squadron |
| AWM Embarkation Roll number | 10/10/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A34 Persic on 21 December 1914 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | aust Prov Cps |
| Fate | Returned to Australia 1 November 1918 |
