| Regimental number | 2716 |
| Place of birth | Box Hill VIC :Place of Enlistment - Footscray Victoria |
| Religion | Salvation Army |
| Occupation | Mechanic |
| Address | Seddon, Victoria |
| Marital status | Married |
| Age at embarkation | 24 |
| Next of kin | Wife, Mrs J E Iversen, c/o Mrs Pearce, Humffray Street, Mount Pleasant, Ballarat, Victoria |
| Enlistment date | 7 January 1918 |
| Date of enlistment from Nominal Roll | 6 December 1917 |
| Rank on enlistment | 2nd Air Mechanic |
| Unit name | Australian Flying Corps, 3rd Special Draft |
| AWM Embarkation Roll number | 8/15/3 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Flying Corps |
| Fate | Returned to Australia 22 September 1919 |
