| Regimental number | 16226 |
| Place of birth | Booleroo Centre, South Australia |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Booleroo Centre, South Australia |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs E Fuller, Booleroo Centre, South Australia |
| Previous military service | Nil |
| Enlistment date | 11 April 1916 |
| Rank on enlistment | Private |
| Unit name | November 1916 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A35 Berrima on 16 December 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Field Ambulance |
| Fate | Returned to Australia 3 September 1919 |
| Other details | Medals: British War Medal, Victory Medal |
