| Regimental number | 12625 |
| Occupation | Butcher |
| Next of kin | Mother, Mrs R A Henderson, Manunui, King Country |
| Rank on embarkation | Rifleman |
| Unit name | New Zealand Expeditionary Force, New Zealand Rifle Brigade, 3rd Reinforcements to 3rd Battalion, G Company |
| Embarkation details | Unit embarked from Wellington on |
| Sources | Nominal Roll Vol. 2: Roll 31, p. 20 |