| Regimental number | 3697 |
| Place of birth | Tiaro Queensland |
| Religion | Church of England |
| Occupation | Carpenter |
| Address | 154 Petrie Terrace, Brisbane, Queensland |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs Rasmine Andersen, Brooloo, Gympie, Queensland |
| Enlistment date | 7 August 1916 |
| Rank on enlistment | Private |
| Unit name | 4th Pioneer Battalion, Reinforcement 9 |
| AWM Embarkation Roll number | 14/16/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A33 Ayrshire on 24 January 1917 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 9th Field Company Engineers |
| Fate | Effective abroad (still overseas) |