| Regimental number | 3165 |
| Religion | Church of England |
| Occupation | Railway employee |
| Address | Miranda, via Sutherland, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Father, P C Petersen, Miranda, via Sutherland, New South Wales |
| Enlistment date | 11 August 1915 |
| Rank on enlistment | Private |
| Unit name | 2nd Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/19/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A69 Warilda on 8 October 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
