| Regimental number | 43766 |
| Occupation | Contractor |
| Next of kin | Mother, Mrs J Jellyman, Stoke, Nelson |
| Rank on embarkation | Trooper |
| Unit name | New Zealand Expeditionary Force, Mounted Rifles Brigade, 28th Reinforcements |
| Embarkation details | Unit embarked from Wellington on board Westralia on |
| Embarkation details | Unit embarked from Wellington on board Westralia on |
| Sources | Nominal Roll Vol. 3: Roll 64, p. 9 |