| Regimental number | 4081 |
| Religion | Church of England |
| Occupation | Tailor |
| Address | 160 Clarendon Street, South Melbourne, Victoria |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Father, N P Peterson, Spadenasjukansat, Sweden |
| Enlistment date | 19 August 1915 |
| Rank on enlistment | Private |
| Unit name | 12th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/29/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT RMS Orontes on 24 November 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
