| Regimental number | 6630 |
| Place of birth | Sydney New South Wales |
| Religion | Roman Catholic |
| Occupation | Presser |
| Address | 218 Riley Street, Surry Hills, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs M A O'Brien, 218 Riley Street, Surry Hills, Sydney, New South Wales |
| Enlistment date | 28 March 1916 |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/21/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A60 Aeneas on 30 September 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Battalion |
| Fate | Returned to Australia 6 February 1917 |
| Miscellaneous details | Also embarked INF4REIN22 |
