| Regimental number | 19902 |
| Place of birth | Marrickville New South Wales |
| Religion | Baptist |
| Occupation | Carpenter |
| Address | Orange, New South Wales |
| Marital status | Married |
| Age at embarkation | 29 |
| Next of kin | W/Mo, Mrs Lena Mizen, address unknown; Mrs Catherine Mizen, Washington Street, West Kogarah, New South Wales |
| Enlistment date | 12 July 1917 |
| Rank on enlistment | Sapper |
| Unit name | August 1917 Reinforcements |
| AWM Embarkation Roll number | 14/42/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on 21 November 1917 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 3rd Field Company Engineers |
| Fate | Returned to Australia 1 August 1919 |
