| Regimental number | 12678 |
| Occupation | Telegraph operator |
| Next of kin | Father, Peter Jack, 84 Randolph Street, Christchurch |
| Rank on embarkation | Sapper |
| Unit name | New Zealand Expeditionary Force, 12th Reinforcements (2nd Draft), New Zealand Signalling Corps |
| Embarkation details | Unit embarked from Wellington on |
| Sources | Nominal Roll Vol. 2: Roll 31, p. 14 |