| Regimental number | 3812 |
| Place of birth | Albany Western Australia |
| Religion | Church of England |
| Occupation | Motor mechanic |
| Address | William Street, Subiaco, Western Australia |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mother, Mrs A A Fagan, Wogalin, Western Australia |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 12th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/29/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A31 Ajana on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Flying Corps |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
