| Regimental number | 641 |
| Place of birth | Bega New South Wales |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | Maryborough, Queensland |
| Marital status | Married |
| Age at embarkation | 23 |
| Next of kin | Wife, Mrs Nelly Kelly, Woondoona Street, Bundaberg, Queensland |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | Machine Gun Company 12, Reinforcement 11 |
| AWM Embarkation Roll number | 24/17/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A11 Ascanius on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Machine Gun Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
