| Regimental number | 5040 |
| Place of birth | St Arnaud Victoria |
| Religion | Roman Catholic |
| Occupation | Carpenter |
| Address | 5 Grosvenor Street, South Yarra, Victoria |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Father, Michael Kelly, 5 Grosvenor Street, South Yarra, Melbourne, Victoria |
| Enlistment date | 7 February 1916 |
| Rank on enlistment | Private |
| Unit name | 22nd Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/39/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A33 Ayrshire on 3 July 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 22nd Battalion |
| Fate | Returned to Australia 15 September 1918 |
