| Regimental number | 79509 |
| Occupation | Carter |
| Next of kin | Mother, Mrs T Bak, Matamau, Hawke's Bay |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 41st Reinforcements, E Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT Ulimaroa on |
| Sources | Nominal Rolls Vol. 4: Roll 87, p. 4 |