| Regimental number | 9866 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Draughtsman |
| Address | Woonoona Avenue, Wahroonga, New South Wales |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs Adelaide Eleanor Fallick, Ebenezer, via Windsor, New South Wales |
| Enlistment date | 23 January 1916 |
| Date of enlistment from Nominal Roll | 23 February 1916 |
| Rank on enlistment | Sapper |
| Unit name | 9th Field Company Engineers |
| AWM Embarkation Roll number | 14/28/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A31 Ajana on 5 July 1916 |
| Regimental number from Nominal Roll | Commissioned |
| Rank from Nominal Roll | Lieutenant |
| Unit from Nominal Roll | 35th Battalion |
| Fate | Returned to Australia 12 July 1919 |
