| Regimental number | 1420 |
| Place of birth | North Coast |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Porepunkah, Victoria |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Father, A Kelly, Orbost, Victoria |
| Enlistment date | 28 July 1915 |
| Rank on enlistment | Private |
| Unit name | 8th Light Horse Regiment, 11th Reinforcement |
| AWM Embarkation Roll number | 10/13/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A6 Clan Mccorquodale on 13 November 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 8th Light Horse Regiment |
| Fate | Returned to Australia 3 July 1919 |
