| Regimental number | R1964 |
| Religion | Church of England |
| Occupation | Railway packer |
| Address | ... |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Sister, Miss A Pedersen, Hessell Bay, Christiania, Norway |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 24th Reinforcement |
| AWM Embarkation Roll number | 23/27/5 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A30 Borda on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 10th Battalion |
| Fate | Killed in Action |
| Other details |
War service: Western Front Medals: British War Medal, Victory Medal |