| Regimental number | 6991 |
| Place of birth | Swamp Oak New South Wales |
| Religion | Roman Catholic |
| Occupation | Wharf labourer |
| Address | 3 Lee Terrace, off Church Street, Newcastle, New South Wales |
| Marital status | Married |
| Age at embarkation | 31 |
| Next of kin | Wife, Mrs K Fuller, 3 Lee Terrace, off Church Street, Newcastle, New South Wales |
| Enlistment date | 9 October 1916 |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 23rd Reinforcement |
| AWM Embarkation Roll number | 23/21/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A29 Suevic on 11 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Battalion |
| Fate | Returned to Australia 21 July 1917 |