| Regimental number | 613 |
| Religion | Church of England |
| Occupation | Printer |
| Address | Alpha Station, Alpha, via Rockhampton, Queensland |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs Margaret Amelia Fuller, Alpha Station, Alpha, via Rockhampton, Queensland |
| Enlistment date | 26 October 1915 |
| Rank on enlistment | Private |
| Unit name | 4th Infantry Battalion, Naval and Military Forces - Special Tropical Corps (November 1914), A Company |
| AWM Embarkation Roll number | 23/112/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT SS Te Anau on 20 November 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
