| Regimental number | 4545 |
| Place of birth | Southport Queensland |
| Religion | Church of England |
| Occupation | Cleaner |
| Address | 212 Liverpool Street, East Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Father, J Sullivan, Wyandra Queen Street, Southport, Queensland |
| Enlistment date | 1 December 1915 |
| Rank on enlistment | Private |
| Unit name | 18th Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/35/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A71 Nestor on 9 April 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |