| Regimental number | 4587 |
| Place of birth | Christiana, Norway |
| Religion | Lutheran |
| Occupation | Confectioner |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Father, H Petersen, Christiania, Norway |
| Enlistment date | 14 August 1915 |
| Place of enlistment | Melbourne, Victoria |
| Rank on enlistment | Private |
| Unit name | 14th Battalion, 14th Reinforcement |
| AWM Embarkation Roll number | 23/31/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A70 Ballarat on 18 February 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
