| Regimental number | 3006 |
| Place of birth | Gympie Queensland |
| Religion | Presbyterian |
| Occupation | Labourer |
| Address | Rockhampton, Queensland |
| Marital status | Single |
| Age at embarkation | 26 |
| Next of kin | Mother, Mrs Jessie Jorgensen, Kilkivan, Queensland |
| Enlistment date | 28 February 1916 |
| Rank on enlistment | Private |
| Unit name | 5th Light Horse Regiment, 22nd Reinforcement |
| AWM Embarkation Roll number | 10/10/5 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A43 Barunga on 26 October 1916 |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 9th Mobile Veterinary Section |
| Fate | Returned to Australia 8 April 1919 |
