| Regimental number | 3517 |
| Place of birth | Mt Morgan Queensland |
| Religion | Church of England |
| Occupation | Furnace tapper |
| Address | Mount Morgan, Queensland |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Step-Father, Fred Fullwood, Bond Street, Sydney,NSW |
| Enlistment date | 28 September 1916 |
| Rank on enlistment | Private |
| Unit name | 52nd Battalion 9th Reinforcement |
| AWM Embarkation Roll number | 23/69/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A33 Ayrshire on 24 January 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 41st Battalion |
| Fate | Effective abroad (still overseas) |
