| Regimental number | 3689 |
| Place of birth | Yarram Victoria |
| Religion | Methodist |
| Occupation | Farmer |
| Address | Korumburra, Victoria |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs M Jensen, Elmleigh, Korumburra, Victoria |
| Previous military service | 45th Infantry |
| Enlistment date | 16 November 1917 |
| Rank on enlistment | Private |
| Unit name | 57th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/74/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on 28 February 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 57th Battalion |
| Fate | Returned to Australia 31 March 1919 |
