| Regimental number | 24/190 |
| Address | Railways, Taihape |
| Marital status | Single |
| Next of kin | Mother, Mrs Elizabeth Jackson, Southbrook, North Canterbury |
| Rank on embarkation | Rifleman |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, New Zealand Rifle Brigade, 2nd Battalion, C Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT 31 Tahiti on |
| Miscellaneous details | Nominal Roll Vol. 1: C Company/2nd NZRB |