| Regimental number | 4761 |
| Place of birth | Bundaberg Queensland |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Mt Perry Road, North Bundaberg, Queensland |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs Annie Louisa Olsen, Mt Perry Road, North Bundaberg, Queensland |
| Enlistment date | 19 January 1916 |
| Rank on enlistment | Private |
| Unit name | 26th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/43/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Mooltan on 12 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Division Train |
| Fate | Returned to Australia 20 July 1919 |