| Regimental number | 4793 |
| Place of birth | Harden New South Wales |
| Religion | Roman Catholic |
| Occupation | Grocer |
| Address | Murrumburrah, New South Wales |
| Marital status | Single |
| Age at embarkation | 31 |
| Next of kin | Mother, Mrs M A Kelly, Clarke Street, Murrumburrah, New South Wales |
| Enlistment date | 23 November 1916 |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/47/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A68 Anchises on 24 January 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 30th Battalion |
| Fate | Returned to Australia 8 January 1919 |
