| Regimental number | 6612 |
| Place of birth | Richmond New South Wales |
| Religion | Church of England |
| Occupation | School teacher |
| Address | Richmond River, New South Wales |
| Marital status | Widower |
| Age at embarkation | 30 |
| Next of kin | Son, A Petersen, South Woodburn, Richmond River, New South Wales |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/34/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A18 Wiltshire on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 17th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
