| Regimental number | 2863 |
| Place of birth | Bathurst New South Wales |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Merredin, Western Australia |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs J Fagan, PO Box 24, Merredin, Western Australia |
| Enlistment date | 19 June 1916 |
| Rank on enlistment | Private |
| Unit name | 5th Pioneer Battalion, Reinforcement 6 |
| AWM Embarkation Roll number | 14/17/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A16 Port Melbourne on 30 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Pioneer Battalion |
| Fate | Returned to Australia 8 April 1917 |
