| Regimental number | 6804 |
| Place of birth | South Yarra, Victoria |
| Religion | Roman Catholic |
| Occupation | Driver |
| Address | Prahran, Victoria |
| Marital status | Married |
| Age at embarkation | 36 |
| Next of kin | Wife, Mrs Mary Donovan, 10 Hillingdon Place, Prahran, Victoria |
| Enlistment date | 22 January 1917 |
| Rank on enlistment | Private |
| Unit name | 23rd Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/40/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A11 Ascanius on 11 May 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 23rd Battalion |
| Fate | Returned to Australia 26 September 1917 |
