| Regimental number | 4065 |
| Place of birth | Temora New South Wales |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Quondary, via Temora, New South Wales |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Father, Frederick John Jepsen, Quondary, via Temora, New South Wales |
| Enlistment date | 4 July 1916 |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/47/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on 7 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 30th Battalion |
| Fate | Returned to Australia 5 April 1919 |
| Discharge date | 18 December 1964 |
| Date of death | 68 |
| Place of burial | Temora Cemetery, NSW |
