| Regimental number | 4877 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Motor engineer |
| Address | Koa Ora Tennyson Road, Ryde, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Father, W Petersen, Kia Ora Tennyson Road, Ryde, New South Wales |
| Enlistment date | 12 July 1915 |
| Rank on enlistment | Private |
| Unit name | 13th Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/30/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A15 Star Of England on 8 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 13th Battalion |
| Fate | Returned to Australia 10 July 1916 |
