| Regimental number | 4825 |
| Place of birth | Coleraine Victoria |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | Coleraine, Victoria |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Father, J O'Brien, Coleraine, Victoria |
| Enlistment date | 12 October 1916 |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/47/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A68 Anchises on 24 January 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 30th Battalion |
| Fate | Returned to Australia 10 March 1918 |
