| Regimental number | 15748 |
| Place of birth | London England |
| Religion | Church of England |
| Occupation | Carpenter |
| Address | Crow's Nest, New South Wales |
| Marital status | Married |
| Age at embarkation | 41 |
| Next of kin | Wife, Mrs Annie Constance Blomgren, 'Neutral', Sicnclair Street, Crow's Nest, North Sydney, New South Wales |
| Enlistment date | 17 April 1916 |
| Date of enlistment from Nominal Roll | 23 March 1916 |
| Rank on enlistment | Driver |
| Unit name | October 1916 Reinforcements |
| AWM Embarkation Roll number | 14/42/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A74 Marathon on 31 October 1916 |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 7th Field Company Engineers |
| Fate | Returned to Australia 12 March 1918 |