| Regimental number | 59126 |
| Place of birth | Lyndhurst New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Lyundhurst via Carcoar, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Father, E Fuller, Lyndhurst via Carcoar, New South Wales |
| Enlistment date | 2 January 1918 |
| Rank on enlistment | Private |
| Unit name | New South Wales Reinforcement 11 |
| AWM Embarkation Roll number | 23/111/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A30 Borda on 17 July 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 17th Battalion |
| Fate | Returned to Australia 22 July 1919 |