| Regimental number | 4909 |
| Place of birth | Clifton Hill Victoria |
| Religion | Roman Catholic |
| Occupation | Horse-driver |
| Address | 277 Hay Street, Kalgoorlie, Western Australia |
| Marital status | Married |
| Age at embarkation | 25 |
| Next of kin | Wife, Mrs R H A Sullivan, 236 Aberdeen Street, Perth, Western Australia |
| Enlistment date | 4 January 1916 |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/33/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A38 Ulysses on 1 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 16th Battalion |
| Fate | Returned to Australia 9 December 1918 |
