| Regimental number | 6773 |
| Place of birth | N/A Tasmania |
| Religion | Presbyterian |
| Occupation | Carter |
| Address | Windsor, Queensland |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs Rose Jensen, Bowen Bridge Road, Windsor, Brisbane, Queensland |
| Enlistment date | 21 May 1917 |
| Rank on enlistment | Private |
| Unit name | 25th Battalion, 20th Reinforcement |
| AWM Embarkation Roll number | 23/42/6 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A20 Hororata on 14 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 25th Battalion |
| Fate | Returned to Australia 30 January 1918 |
