| Regimental number | 304 |
| Place of birth | Jerslev Denmark |
| Religion | Presbyterian |
| Occupation | Miner |
| Address | Kingsthorpe, Queensland |
| Marital status | Married |
| Age at embarkation | 39 |
| Next of kin | Wife, Mrs Josephine T C Larsen, Kingsthorpe, Queensland |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 11th Light Horse Regiment, B Squadron |
| AWM Embarkation Roll number | 10/16/1 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A7 Medic on |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A30 Borda on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Light Horse Regiment |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
