| Regimental number | 221 |
| Place of birth | Goulburn New South Wales |
| Religion | Baptist |
| Occupation | Station hand |
| Marital status | Single |
| Age at embarkation | 34 |
| Next of kin | Mother, Mrs F. Fuller, Horton Street, Marrickville, Sydney, New South Wales |
| Enlistment date | 3 November 1914 |
| Rank on enlistment | Private |
| Unit name | 7th Light Horse Regiment, A Squadron |
| AWM Embarkation Roll number | 10/12/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A33 Ayrshire on 20 December 1914 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 7th Light Horse Regiment |
| Fate | Returned to Australia 22 December 1918 |
