| Regimental number | 2223A |
| Place of birth | Toedestraud Norway |
| Religion | Lutheran |
| Occupation | Labourer |
| Address | Murray Bridge, South Australia |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Sister, Miss Johanne Pedersen, Pla Park Lane, Washington, USA |
| Enlistment date | 2 May 1916 |
| Rank on enlistment | Private |
| Unit name | 48th Battalion, 4th Reinforcement |
| AWM Embarkation Roll number | 23/65/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A70 Ballarat on 12 August 1916 |
| Regimental number from Nominal Roll | 2223 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 48th Battalion |
| Fate | Returned to Australia 20 December 1917 |