| Regimental number | 3862 |
| Place of birth | Sydney New South Wales |
| Religion | Presbyterian |
| Occupation | Blacksmith |
| Address | 31 Amy Street, Erskineville, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs M Madson, 31 Amy Street, Erskineville, New South Wales |
| Enlistment date | 24 August 1915 |
| Rank on enlistment | Private |
| Unit name | 2nd Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/19/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 30 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Battalion |
| Fate | Returned to Australia 21 January 1919 |
| Miscellaneous details (Nominal Roll) | *second given name is Charles |
