| Regimental number | 5963 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Engineer |
| Address | 88 Harris Street, Pyrmont, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs Sarah Ann Kelly, 88 Harris Street, Pyrmont, Sydney, New South Wales |
| Enlistment date | 13 November 1915 |
| Rank on enlistment | Sapper |
| Unit name | 7th Field Company Engineers, Reinforcement 3 |
| AWM Embarkation Roll number | 14/26/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A54 Runic on 20 January 1916 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 4th Field Company Engineers |
| Fate | Returned to Australia 12 May 1919 |