| Regimental number | 56612 |
| Occupation | Labourer |
| Next of kin | Mother, Mrs E Theobald, Matata |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 28th Reinforcements (Second Draft), Canterbury Infantry Regiment, C Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT Ulimaroa on |
| Sources | Nominal Roll Vol. 3: Roll 69, p. 24 |