| Regimental number | 3371 |
| Place of birth | Tupord Denmark |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Hart Street, Glanville, South Australia |
| Marital status | Married |
| Age at embarkation | 25 |
| Next of kin | Wife, Mrs C C Jensen, Hart Street, Glanville, South Australia |
| Enlistment date | 28 July 1915 |
| Date of enlistment from Nominal Roll | 26 July 1915 |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/27/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A24 Benalla on 27 October 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 50th Battalion |
| Fate | Returned to Australia 19 June 1919 |