| Regimental number | 16386 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Mechanic (linotype) |
| Address | Broken Hill, New South Wales |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs Hansine Andersen, Kincheger Station, River Darling, New South Wales |
| Enlistment date | 25 May 1916 |
| Rank on enlistment | Sapper |
| Unit name | 5th Divisional Signal Company (Engineers), 8th Reinforcements |
| AWM Embarkation Roll number | 22/15/4 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A35 Berrima on 16 December 1916 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 5th Divisional Signal Company |
| Fate | Returned to Australia 20 December 1917 |
