| Regimental number | 3855 |
| Place of birth | Prahran Victoria |
| Religion | Church of England |
| Occupation | Driver |
| Address | North Melbourne, Victoria |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Father, N Mikkelsen, 11 Barwise Street, North Melbourne, Victoria |
| Enlistment date | 26 July 1915 |
| Rank on enlistment | Private |
| Unit name | 6th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/23/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A40 Ceramic on 23 November 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 6th Battalion |
| Fate | Returned to Australia 21 December 1918 |
