| Regimental number | 11963 |
| Place of birth | Melbourne Victoria |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | Wollert Post Office, via Epping, Victoria |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mother, Mrs M E Kelly, Wollert Post Office, via Epping, Victoria |
| Enlistment date | |
| Rank on enlistment | Gunner |
| Unit name | Divisional Ammunition Column 1, Reinforcement 14 |
| AWM Embarkation Roll number | 25/89/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A32 Themistocles on |
| Rank from Nominal Roll | Gunner |
| Unit from Nominal Roll | 14th Field Artillery Brigade |
| Fate | Returned to Australia |
| Miscellaneous information from cemetery records | Plaque in Victorian Garden of Remembrance |
| Date of death |