| Regimental number | 1189 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Walker Street, Fivedock, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Mrs M Andersen, Walker Street, Fivedock, New South Wales |
| Enlistment date | 1 May 1916 |
| Rank on enlistment | Private |
| Unit name | Light Trench Mortar Battery, Reinforcement 2 |
| AWM Embarkation Roll number | 13/130/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on 7 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Light Trench Mortar Battery |
| Fate | Returned to Australia 30 April 1919 |
