| Regimental number | 7618 |
| Place of birth | Lillesand Norway |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Adelaide, South Australia |
| Marital status | Single |
| Age at embarkation | 35 |
| Next of kin | Mother, Mrs Petronella Jacobsen, Millesand, Norway |
| Enlistment date | |
| Rank on enlistment | Sapper |
| Unit name | April 1917 Reinforcements |
| AWM Embarkation Roll number | 16/15/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A68 Anchises on |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | Tunnelling Companies Reinforcements |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
