| Regimental number | 3989 |
| Place of birth | Melbourne Victoria |
| Religion | Church of England |
| Occupation | Driver |
| Address | W Myrtle C Jorgensen, 83 Charles Street, Abbotsford, Victoria |
| Marital status | Married |
| Age at embarkation | 22 |
| Next of kin | Wife, Mrs Myrtle C Jorgensen, Broadmeadows PO, Broadmeadows, Melbourne, Victoria |
| Enlistment date | 9 November 1915 |
| Rank on enlistment | Private |
| Unit name | 24th Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 23/41/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A69 Warilda on 8 February 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Machine Gun Battalion Details |
| Fate | Returned to Australia 24 August 1918 |
