| Regimental number | 1660 |
| Place of birth | Brisbane Queensland |
| Religion | Presbyterian |
| Occupation | Warehouseman |
| Address | West End, Queensland |
| Marital status | Married |
| Age at embarkation | 27 |
| 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 |
| Rank on enlistment | Private |
| Unit name | Convalescent Depot, Harefield Park, London |
| AWM Embarkation Roll number | 26/84/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A67 Orsova on 14 July 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Australian General Hospital |
| Fate | Returned to Australia 15 May 1919 |
