| Regimental number | 5060 |
| Religion | Roman Catholic |
| Occupation | Sailor |
| Address | Leederville, Western Australia |
| Marital status | Married |
| Age at embarkation | 34 |
| Next of kin | Wife, Mrs Ellen Petersen, 223 Loftus Street, Leederville, Western Australia |
| Enlistment date | 6 March 1916 |
| Rank on enlistment | Private |
| Unit name | 28th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/45/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A48 Seang Bee on 18 July 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 28th Battalion |
| Fate | Returned to Australia 23 July 1919 |
