| Regimental number | 4757 |
| Place of birth | Sydney New South Wales |
| Religion | Roman Catholic |
| Occupation | Farm hand |
| Address | Weston Road, Rozelle, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Sister, E Peterson, Weston Road, Rozelle, New South Wales |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/36/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 18th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
