| Regimental number | 1660 |
| Religion | Presbyterian |
| Occupation | Warehouseman |
| Address | c/o Mrs C B Petersen, c/o Mrs C H Bell, Boundary Street, West End, Brisbane, Queensland |
| Marital status | Married |
| Age at embarkation | 28 |
| Next of kin | Wife, Mrs C B Petersen, c/o Mrs C H Bell, Boundary Street, West End, Brisbane, Queensland |
| Enlistment date | 10 June 1915 |
| Date of enlistment from Nominal Roll | 10 June 1915 |
| Rank on enlistment | Private |
| Unit name | AMC Convalescent Depot |
| AWM Embarkation Roll number | 26/84/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A67 Orsova on 14 July 1915 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A67 Orsova on 22 July 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | No 1 Australian General Hospital |
| Fate | Returned to Australia 15 May 1919 |
