| Regimental number | 6513 |
| Place of birth | Eaglehawk Tasmania |
| Religion | Church of England |
| Occupation | Shop assistant |
| Address | Eaglehawk Neck, Tasmania |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Father, S Fazackerley, Eaglehawk Neck, Tasmania |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 3rd Field Ambulance, 12th Reinforcement |
| AWM Embarkation Roll number | 26/46/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT RMS Orontes on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Stationary Hospital |
| Fate | Returned to Australia |
| Date of death | |
| Place of burial | Cornelian Bay Crematorium |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
