| Regimental number | 4149 |
| Place of birth | Port Darwin South Australia |
| Religion | Church of England |
| Occupation | Porter, SA railways |
| Address | 33 Park Terrace, Parkside, South Australia |
| Marital status | Married |
| Age at embarkation | 30 |
| Next of kin | Wife, Mrs Mabel Beatrice Kelsey, 33 Park Terrace, Parkside, South Australia |
| Enlistment date | 6 December 1915 |
| Rank on enlistment | Private |
| Unit name | 27th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/44/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board RMS Mongolia on 9 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 27th Battalion |
| Fate | Returned to Australia 11 December 1918 |
