| Regimental number | 17299 |
| Occupation | Clerk |
| Next of kin | Father, Richard Jack, 75 Maitland Street, Dunedin |
| Rank on embarkation | Corporal |
| Unit name | New Zealand Expeditionary Force, 21st Reinforcements, New Zealand Field Artillery |
| Embarkation details | Unit embarked from Wellington on board Waitemata on |
| Sources | Nominal Roll Vol. 3: Roll 52, p. 22 |