| Regimental number | 1853 |
| Place of birth | Adelaide, South Australia |
| Religion | Church of England |
| Occupation | Bushman |
| Address | Meekatharra, Western Australia |
| Marital status | Single |
| Age at embarkation | 40 |
| Next of kin | Sister, Mrs Anne Fuller, Clifton Street, Hawthorne, South Australia |
| Enlistment date | 22 October 1915 |
| Date of enlistment from Nominal Roll | 16 October 1915 |
| Rank on enlistment | Private |
| Unit name | 10th Light Horse Regiment, 13th Reinforcement |
| AWM Embarkation Roll number | 10/15/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A30 Borda on 17 January 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Veterinary Hospital |
| Fate | Returned to Australia 8 August 1918 |
