| Regimental number | 2783 |
| Place of birth | Copenhagen Denmark |
| Religion | Methodist |
| Occupation | Sawyer |
| Address | Toowoomba, Queensland |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Father, James Peter Petersen, Perseverance via Murphy's Creek, Queensland |
| Enlistment date | 15 March 1916 |
| Rank on enlistment | Private |
| Unit name | 47th Battalion, 6th Reinforcement |
| AWM Embarkation Roll number | 23/64/3 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A74 Marathon on 27 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 47th Battalion |
| Fate | Returned to Australia 21 July 1917 |
