| Regimental number | 6492 |
| Place of birth | Grand Tall South Australia |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Hopetoun PO, Victoria |
| Marital status | Single |
| Age at embarkation | 43 |
| Next of kin | Mother, Mrs L S Fullgrabe, Hopetoun PO, Victoria |
| Enlistment date | 17 June 1916 |
| Rank on enlistment | Private |
| Unit name | 6th Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/23/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on 2 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 6th Battalion |
| Fate | Returned to Australia 30 January 1918 |
