| Regimental number | 5327 |
| Place of birth | Maryborough Queensland |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Gilford Road, Kalamunda, Western Australia |
| Marital status | Married |
| Age at embarkation | 27 |
| Next of kin | Wife, Mrs G A Jorgensen, Gilford Road, Kalamunda, Western Australia |
| Enlistment date | 20 December 1915 |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/33/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A60 Aeneas on 17 April 1916 |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 16th Battalion |
| Fate | Returned to Australia 10 September 1917 |
