| Regimental number | 8003 |
| Place of birth | Freidrickstat Norway |
| Religion | Lutheran |
| Occupation | Fisherman |
| Address | Geraldton, Western Australia |
| Marital status | Single |
| Age at embarkation | 26 |
| Next of kin | Mother, Mrs M Jorgensen, Fredrikstad PO, Fredrikstad, Norway |
| Enlistment date | 5 July 1917 |
| Date of enlistment from Nominal Roll | 2 April 1917 |
| Rank on enlistment | Private |
| Unit name | 39th Battalion, 8th Reinforcement |
| AWM Embarkation Roll number | 23/56/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A18 Wiltshire on 2 February 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Battalion |
| Fate | Discharged 31/--/1919 |
