| Regimental number | 1469 |
| Place of birth | Ballan Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Bradshaw, via Ballan, Victoria |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Father, W Fisk, via Ballan, Victoria |
| Enlistment date | 1 July 1915 |
| Rank on enlistment | Private |
| Unit name | 4th Light Horse Regiment, 11th Reinforcement |
| AWM Embarkation Roll number | 10/9/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A56 Palermo on 29 October 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
