| Regimental number | 2124 |
| Place of birth | Middle Park, Victoria |
| Religion | Baptist |
| Occupation | Brassmoulder |
| Address | 42 Little Page Street, Albert Park, Victoria |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, Mr A Andersen, 42 Little Page Street, Albert Park, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 57th Battalion, 4th Reinforcement |
| AWM Embarkation Roll number | 23/74/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A67 Orsova on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 59th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
