| Regimental number | 6751 |
| Religion | Church of England |
| Occupation | Labourer |
| Address | The Rock, New South Wales |
| Marital status | Married |
| Age at embarkation | 38 |
| Next of kin | Wife, Mrs A R Fuller, The Rock, New South Wales |
| Enlistment date | 24 May 1916 |
| Rank on enlistment | Private |
| Unit name | 7th Battalion, 22nd Reinforcement |
| AWM Embarkation Roll number | 23/24/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT SS Port Napier on 17 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 7th Battalion |
| Fate | Returned to Australia 1 November 1917 |
