| Regimental number | 649 |
| Place of birth | Rockhampton Queensland |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Rockhampton, Queensland |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs Elizabeth Pedersen, St Lawrence, Queensland |
| Enlistment date | 15 September 1916 |
| Rank on enlistment | Private |
| Unit name | Machine Gun Company 7, Reinforcement 11 |
| AWM Embarkation Roll number | 24/12/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A46 Clan Macgillivray on 10 May 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Machine Gun Battalion |
| Fate | Returned to Australia 23 July 1919 |
