| Regimental number | 10264 |
| Place of birth | Larvick Norway |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 75 Reynold Street, Balmain, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, C Johnsen, 75 Reynold Street, Balmain, New South Wales |
| Enlistment date | 7 September 1915 |
| Date of enlistment from Nominal Roll | 31 August 1915 |
| Rank on enlistment | Gunner |
| Unit name | Divisional Ammunition Column 2, Reinforcement 2 |
| AWM Embarkation Roll number | 25/90/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A35 Berrima on 17 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 18th Battalion |
| Fate | Returned to Australia 12 December 1918 |
