| Regimental number | 3817 |
| Religion | Church of England |
| Occupation | Labourer |
| Marital status | Single |
| Age at embarkation | 32 |
| Next of kin | Brother, C Mongenson, Gorlose Per Salangloup, Denmark |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/27/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board RMS Malwa on |
| Rank from Nominal Roll | Private |