| Regimental number | 3103 |
| Place of birth | Portland Victoria |
| Religion | Presbyterian |
| Occupation | Labourer |
| Address | Wallan Wallan, Victoria |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Father, N Neilsen, Wallan Wallan, Victoria |
| Enlistment date | 5 July 1915 |
| Rank on enlistment | Private |
| Unit name | 14th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/31/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A17 Port Lincoln on 16 October 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
| Date of death | 22 October 1962 |
| Place of burial | Altona Cemetery |
