| Regimental number | 81127 |
| Occupation | Labourer |
| Next of kin | Mother, Mrs Margaret Jacobs, Toko, Taranaki |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 41st Reinforcements, F Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT Ulimaroa on |
| Sources | Nominal Rolls Vol. 4: Roll 87, p. 9 |