| Regimental number | 17187 |
| Occupation | Painter |
| Next of kin | Mother, Mrs F E Haase, Ngatiawa Street, Nelson |
| Rank on embarkation | Gunner |
| Unit name | New Zealand Expeditionary Force, 16th Reinforcements, New Zealand Field Artillery |
| Embarkation details | Unit embarked from Wellington on board HMNZT 61 Aparima on |
| Sources | Nominal Roll Vol. 2: Roll 38, p. 22 |