| Regimental number | 5705 |
| Place of birth | Nykirk Denmark |
| Religion | Protestant |
| Occupation | Farmer |
| Address | Adelaide, South Australia |
| Marital status | Single |
| Age at embarkation | 35 |
| Next of kin | Mother, Mrs Karen Hansen, Greysdale, Pr Veile, Denmark |
| Enlistment date | 16 September 1916 |
| Date of enlistment from Nominal Roll | 16 September 1915 |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 18th Reinforcement |
| AWM Embarkation Roll number | 23/27/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A37 Barambah on 27 June 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 48th Battalion |
| Fate | Returned to Australia 1 November 1917 |
