| Regimental number | 5769 |
| Place of birth | Breadalbane New South Wales |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | Cullerin PO, via Goulburn, New South Wales |
| Marital status | Single |
| Age at embarkation | 33 |
| Next of kin | Father, T Sullivan, Breadalbane, New South Wales |
| Enlistment date | 24 November 1915 |
| Rank on enlistment | Private |
| Unit name | 1st Battalion, 18th Reinforcement |
| AWM Embarkation Roll number | 23/18/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A55 Kyarra on 3 June 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Battalion |
| Fate | Returned to Australia 4 May 1917 |
