| Regimental number | 2903 |
| Place of birth | Kadina South Australia |
| Religion | Methodist |
| Occupation | Brewery employee |
| Address | 112 Richardson Street, Boulder, Western Australia |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Father, H Kelly, 112 Richardson Street, Boulder, Western Australia |
| Enlistment date | 23 July 1915 |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 23/33/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A20 Hororata on 5 October 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 16th Battalion |
| Fate | Returned to Australia 28 February 1919 |
