| Regimental number | 6946 |
| Place of birth | Odsense Denmark |
| Religion | Church of England |
| Occupation | Blacksmith |
| Address | C/o Mrs N Andersen, Toowoomba, Queensland |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs L J Andersen, Toowoomba, Queensland |
| Enlistment date | 2 November 1916 |
| Date of enlistment from Nominal Roll | 2 November 1916 |
| Rank on enlistment | Private |
| Unit name | 3rd Battalion, 23rd Reinforcement |
| AWM Embarkation Roll number | 23/20/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A24 Benalla on 9 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Veterinary Hospital |
| Fate | Returned to Australia 8 November 1918 |
