| Regimental number | 28590 |
| Religion | Congregational |
| Occupation | Farmer |
| Address | 30 The Avenue, Balaclava, Victoria |
| Marital status | Married |
| Age at embarkation | 32 |
| Next of kin | Wife, Mrs W G Fulwood, 30 The Avenue, Balaclava, Victoria |
| Enlistment date | 10 May 1916 |
| Rank on enlistment | Gunner |
| Unit name | Howitzer Brigade 23, Reinforcement 7 |
| AWM Embarkation Roll number | 13/133/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A38 Ulysses on 25 October 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |