| Regimental number | 2191 |
| Place of birth | Tipperary Ireland |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | Goulburn, New South Wales |
| Marital status | Single |
| Age at embarkation | 39 |
| Next of kin | Cousin, George Leslie Kelly, GPO Box 327, St John Street, New Brunswick, Canada |
| Enlistment date | 17 April 1916 |
| Rank on enlistment | Private |
| Unit name | 36th Battalion, 3rd Reinforcement |
| AWM Embarkation Roll number | 23/53/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A68 Anchises on 24 August 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 36th Battalion |
| Fate | Returned to Australia 4 May 1917 |