| Regimental number | 3664 |
| Place of birth | Dunedin New Zealand |
| Religion | Church of England |
| Occupation | Butcher |
| Address | Glenreagh, New South Wales |
| Marital status | Single |
| Age at embarkation | 31 |
| Next of kin | Aunt, Catherine Ross Kelly, 11 St. David Street, Dunedin, New Zealand |
| Enlistment date | 22 November 1916 |
| Rank on enlistment | Private |
| Unit name | 1st Pioneer Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 14/13/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A68 Anchises on 24 January 1917 |
