| Regimental number | 4746 |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Bundaberg, Queensland |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs Ablina Charlotte Nielson, Bundaberg, Queensland |
| Enlistment date | 8 January 1916 |
| Rank on enlistment | Private |
| Unit name | 25th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/42/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Mooltan on 12 April 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
