| Regimental number | 2200 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Shearer |
| Address | 60 Ernest Street, North Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 32 |
| Next of kin | Mother, Mrs Harriet Fuller, Addison Street, South Goulburn, New South Wales |
| Enlistment date | 10 April 1916 |
| Rank on enlistment | Private |
| Unit name | 33rd Battalion, 3rd Reinforcement |
| AWM Embarkation Roll number | 23/50/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A68 Anchises on 24 August 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 33rd Battalion |
| Fate | Returned to Australia 10 September 1917 |
