| Regimental number | 12607 |
| Occupation | Grocer |
| Next of kin | Mother, Mrs Grace Jackson, Albert Street, Onehunga, Auckland |
| Rank on embarkation | Trooper |
| Unit name | New Zealand Expeditionary Force, 12th Reinforcements (2nd Draft), New Zealand Mounted Rifles Brigade |
| Embarkation details | Unit embarked from Wellington on |
| Sources | Nominal Roll Vol. 2: Roll 31, p. 2 |