| Regimental number | 5140 |
| Place of birth | Lal Lal Victoria |
| Religion | Methodist |
| Occupation | Labourer |
| Address | Cobden, Victoria |
| Marital status | Married |
| Age at embarkation | 43 |
| Next of kin | Wife, Mrs S H Ann Rasmussen, Curdin Street, Cobden, Victoria |
| Enlistment date | 10 October 1914 |
| Date of enlistment from Nominal Roll | 7 September 1916 |
| Rank on enlistment | Sapper |
| Unit name | Tunnelling Companies, 2nd Reinforcement |
| AWM Embarkation Roll number | 16/13/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A26 Armadale on 19 July 1916 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 2nd Tunnelling Company |
| Fate | Returned to Australia 10 January 1918 |