| Regimental number | 6420 |
| Religion | Lutheran |
| Occupation | Miner |
| Address | Wynum Lane off Zebena Street, Broken Hill, New South Wales |
| Marital status | Married |
| Age at embarkation | 30 |
| Next of kin | Wife, Mrs Lavinia West Peterson, c/o Dyers Hotel, Nevens Creek, Broken Hill, New South Wales |
| Enlistment date | 20 August 1915 |
| Rank on enlistment | Sapper |
| Unit name | 3rd Field Company Engineers, Reinforcement 15 |
| AWM Embarkation Roll number | 14/22/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A26 Armadale on 20 March 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
