| Regimental number | 1004 |
| Place of birth | Ballarat Victoria |
| Religion | RF |
| Occupation | Miner |
| Address | Meekatharra, Western Australia |
| Marital status | Single |
| Age at embarkation | 41 |
| Next of kin | Mother, Mrs Margaret Fogarty, Daylesford, Victoria |
| Enlistment date | |
| Rank on enlistment | Sapper |
| Unit name | Mining Corps, Company 3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A38 Ulysses on |
| Rank from Nominal Roll | Sergeant |
| Unit from Nominal Roll | 3rd Tunnelling Company |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
