| 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 | 17 October 1916 |
| Date of enlistment from Nominal Roll | 7 October 1916 |
| 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 11 May 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Machine Gun Battalion |
| Fate | Returned to Australia 11 January 1918 |
