| Regimental number | 3077 |
| Place of birth | Leichhardt, New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Carey Street, Marrickville, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Sister, Miss A. Mortensen, Carey Street, Marrickville, Sydney, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 9th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/26/3 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A69 Warilda on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 9th Battalion |
| Other details from Roll of Honour Circular | Died 20/4/16 |
| Fate | Killed in Action |
| Place of death or wounding | France |
| Age at death from cemetery records | 17 |
| Place of burial | Rue-du-Escquerot (19th London) Graveyard (Row f, Grave No. 40), Laventie, France |
| Panel number, Roll of Honour, Australian War Memorial | 57 |
| Miscellaneous information from cemetery records | Parents: Peter and Therese MADSEN |