| Regimental number | 4195 |
| Place of birth | Ballarat Victoria |
| Religion | Church of England |
| Occupation | Locomotive driver |
| Address | Harvey, Western Australia |
| Marital status | Single |
| Age at embarkation | 35 |
| Next of kin | Mother, Mrs M A Fisk, Guildford Road, Maylands, Western Australia |
| Enlistment date | 20 September 1915 |
| Date of enlistment from Nominal Roll | 14 September 1915 |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/28/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A30 Borda on 17 January 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Battalion |
| Fate | Returned to Australia 19 April 1919 |
