| Regimental number | 21696 |
| Occupation | Teamster |
| Next of kin | Father, W Jury, White's Bridge, Kaiapoi |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 16th Reinforcements, Canterbury Infantry Battalion, C Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT 62 Mokoia on |
| Sources | Nominal Roll Vol. 2: Roll 38, p. 14 |