| Regimental number | 2480 |
| Place of birth | Cumberland New South Wales |
| Religion | Church of England |
| Occupation | Ironworker |
| Address | Balmain, New South Wales |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs. H. Jorgensen, 2 Caroline Street, Balmain, New South Wales |
| Enlistment date | 3 January 1916 |
| Date of enlistment from Nominal Roll | 25 January 1916 |
| Rank on enlistment | Private |
| Unit name | 31st Battalion, 4th Reinforcement |
| AWM Embarkation Roll number | 23/48/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A68 Anchises on 14 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 31st Battalion |
| Fate | Returned to Australia 1 February 1918 |
