| Regimental number | 7021 |
| Place of birth | Quorn South Australia |
| Religion | Methodist |
| Occupation | Farmer |
| Address | Galong, New South Wales |
| Marital status | Single |
| Age at embarkation | 32 |
| Next of kin | Father, J M Kelly, Itali Itali, Kingswood North, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 13th Battalion, 23rd Reinforcement |
| AWM Embarkation Roll number | 23/30/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on |