| Regimental number | 15612 |
| Place of birth | Ilfracombe England |
| Religion | Church of England |
| Occupation | Plumber |
| Address | Brisbane, Queensland |
| Marital status | Married |
| Age at embarkation | 28 |
| Next of kin | Wife, Mrs Edith Alice Fisher, 256 Park Road, Paddington, Sydney, New South Wales |
| Enlistment date | 20 January 1916 |
| Rank on enlistment | Sapper |
| Unit name | October 1916 Reinforcements |
| AWM Embarkation Roll number | 14/42/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A74 Marathon on 31 October 1916 |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | at Engrs |
| Fate | Returned to Australia 13 April 1919 |
