| Regimental number | 2641 |
| Place of birth | Fremantle, Western Australia |
| Religion | Church of England |
| Occupation | Jeweller |
| Address | Fremantle, Western Australia |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs Sarah Carlson, 138 Gore Street, Fitzroy, Melbourne, Victoria |
| Enlistment date | 19 June 1916 |
| Rank on enlistment | Private |
| Unit name | 51st Battalion, 6th Reinforcement |
| AWM Embarkation Roll number | 23/68/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A23 Suffolk on 10 October 1916 |
| Regimental number from Nominal Roll | 2641A |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Machine Gun Details |
| Fate | Returned to Australia 28 February 1919 |
