| Regimental number | 1721 |
| Place of birth | South Brisbane Queensland |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Terrors Creek via Petrie, Queensland |
| Marital status | Married |
| Age at embarkation | 27 |
| Next of kin | Wife, Mrs Maud Poulsen, Fordwich Estate, Broke via Singleton, New South Wales |
| Enlistment date | 28 December 1915 |
| Rank on enlistment | Private |
| Unit name | 11th Light Horse Regiment, 8th Reinforcement |
| AWM Embarkation Roll number | 10/16/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A10 Karoo on 5 May 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Australian Stationary Hospital |
| Fate | Returned to Australia 15 June 1919 |
