| Regimental number | 3065 |
| Place of birth | Wagga Wagga New South Wales |
| Religion | Roman Catholic |
| Occupation | Driver |
| Address | 100 Great Buckingham Street, Redfern, New South Wales |
| Marital status | Married |
| Age at embarkation | 36 |
| Next of kin | Wife, Mrs Sarah Margaret Kelleher, 100 Great Buckingham Street, Redfern, New South Wales |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 1st Light Horse Regiment, 23rd Reinforcement |
| AWM Embarkation Roll number | 10/6/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Karmala on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Light Horse Regiment |
| Recommendations (Medals and Awards) |
Military Medal Recommendation date: |
| Fate | Returned to Australia |
| Medals |
Military Medal Source: 'Commonwealth Gazette' No. 95 Date: |