| Regimental number | 102 |
| Place of birth | Gootchie Queensland |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Brisbane, Queensland |
| Marital status | Single |
| Age at embarkation | 35 |
| Next of kin | Sister, Mrs Bertha Carlsen, Kandaga via Gympie, Queensland |
| Enlistment date | 9 September 1915 |
| Rank on enlistment | Private |
| Unit name | 14th Light Horse Regiment, A Squadron |
| AWM Embarkation Roll number | 10/19/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on 13 May 1916 |
| Regimental number from Nominal Roll | 62 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 15th Battalion |
| Fate | Returned to Australia 22 July 1917 |