| Regimental number | 3419 |
| Place of birth | Saddleworth South Australia |
| Religion | Roman Catholic |
| Occupation | Clerk |
| Address | Military Road, Semaphore, South Australia |
| Marital status | Married |
| Age at embarkation | 32 |
| Next of kin | Wife, Mrs Gwendoline Rose Kelly, Military Road, Semaphore, South Australia |
| Enlistment date | 10 April 1917 |
| Rank on enlistment | Private |
| Unit name | 9th Light Horse Regiment, 29th Reinforcement |
| AWM Embarkation Roll number | 10/14/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A55 Kyarra on 7 September 1917 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A73 Commonwealth on 2 November 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 9th Light Horse Regiment |
| Fate | Returned to Australia 15 June 1919 |
