| Regimental number | 6764A |
| Religion | Church of England |
| Occupation | Driver |
| Address | Williamstown, Victoria |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mother, Mrs A.O. Andersen, Elizabeth Street, Norwood, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 24th Battalion, 20th Reinforcements |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 24th Battalion |
| Fate | Returned to Australia |
| Other details |
War service: Western Front Medals: British War Medal, Victory Medal |