| Regimental number | 3811 |
| Religion | Methodist |
| Occupation | Ironmoulder |
| Address | Wallaroo, South Australia |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs A Fulchun c/o Mrs Surfield, Wallaroo, South Australia |
| Enlistment date | 30 August 1915 |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/27/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board RMS Malwa on 2 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 10th Battalion |
| Fate | Returned to Australia 18 July 1919 |