| Regimental number | 2133 |
| Place of birth | Northham Western Australia |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | c/o George Fagan, Perth Road, Albany, Western Australia |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Father, George Fagan, Perth Road, Albany, Western Australia |
| Enlistment date | 3 May 1915 |
| Date of enlistment from Nominal Roll | 4 May 1915 |
| Rank on enlistment | Driver PTE |
| Unit name | 11th Battalion, 6th Reinforcement |
| AWM Embarkation Roll number | 23/28/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A2 Geelong on 6 June 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Battalion |
| Fate | Returned to Australia 21 March 1919 |
