| Regimental number | 7709 |
| Place of birth | Esberg Denmark |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Murwillumbah, New South Wales |
| Marital status | Married |
| Age at embarkation | 40 |
| Next of kin | Wife, Mrs D M Jensen, George Street PO, Brisbane, Queensland |
| Enlistment date | 25 July 1917 |
| Rank on enlistment | Private |
| Unit name | 15th Battalion, 26th Reinforcement |
| AWM Embarkation Roll number | 23/32/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A14 Euripides on 31 October 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 15th Battalion |
| Fate | Returned to Australia 1 July 1919 |
