| Regimental number | 1067 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Mechanical engineer |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mother, Mrs Elizabeth Fanny Hansen, 'Roskilda', Wollongong Road, Arncliffe, Sydney, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Australian Flying Corps, No 4 Squadron, C Flight |
| AWM Embarkation Roll number | 8/7/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Omrah on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Squadron Australian Flying Corps |
| Fate | Returned to Australia |
| Date of death | |
| Place of burial | Woronora Crematorium |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
