| Regimental number | 4370 |
| Place of birth | Fredericia Denmark |
| Religion | Church of England |
| Occupation | Sailor |
| Address | Northam, Western Australia |
| Marital status | Married |
| Age at embarkation | 21 |
| Next of kin | Wife, Mrs R A Mikkelsen, 142 Victoria Street, West Richmond, Victoria |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 2nd Pioneer Battalion, Reinforcement 12 |
| AWM Embarkation Roll number | 14/14/6 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A60 Aeneas on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Corps Signals |
| Fate | Effective abroad (still overseas) |
| Other details |
War service: Western Front |