| Regimental number | 56609 |
| Occupation | Farmer |
| Next of kin | Mother, Mrs M Jacobs, Horotiu |
| Rank on embarkation | Corporal |
| Unit name | New Zealand Expeditionary Force, 35th Reinforcements, Specialist Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT Tofua on |
| Sources | Nominal Rolls Vol. 4: Roll 80, p. 14 |