| Regimental number | 10079 |
| Place of birth | Woodburn New South Wales |
| Religion | Church of England |
| Occupation | Carpenter |
| Address | Ocean View, South Woodburn, Richmond River, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, A Petersen, Ocean View, South Woodburn, Richmond River, New South Wales |
| Enlistment date | 30 August 1915 |
| Rank on enlistment | Gunner |
| Unit name | Field Artillery Brigade 3, Reinforcement 13 |
| AWM Embarkation Roll number | 13/31/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A35 Berrima on 17 December 1915 |
| Rank from Nominal Roll | Gunner |
| Unit from Nominal Roll | 1st Division Medium Trench Mortar Battery |
| Fate | Returned to Australia 12 April 1919 |
