| Regimental number | 5092 |
| Place of birth | Ballarat Victoria |
| True Name | FALLON |
| Religion | Church of England |
| Occupation | Tinsmith |
| Address | 159 Union Street, Newtown, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Friend, Miss M. Baldwin, 159 Union Street, Newtown, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/21/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Makarini on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 30th Battalion |
| Fate | Returned to Australia |
| Other details |
War service: Western Front Medals: British War Medal, Victory Medal |