| Regimental number | 28785 |
| Place of birth | Dunedin New Zealand |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Greens Road, Paddington, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs H Petersen, Gatepa, Tauranga, New Zealand |
| Enlistment date | 19 April 1916 |
| Rank on enlistment | Gunner |
| Unit name | Medium Trench Mortar Battery Reinforcement 1 |
| AWM Embarkation Roll number | 13/129/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A47 Mashobra on 14 September 1916 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 4th Divisional Signal Company |
| Fate | Returned to Australia 16 March 1919 |
