| Regimental number | 56804 |
| Occupation | Grocer's assistant |
| Next of kin | Wife, Mrs Alice Helena Larsen, c/o P.O. Box 120, Hawera |
| Rank on embarkation | Rifleman |
| Unit name | New Zealand Expeditionary Force, New Zealand Rifle Brigade Reinforcements (Second Draft), H Company (Part) |
| Embarkation details | Unit embarked from Wellington on board HMNZT 89 Waitemata on |
| Sources | Nominal Roll Vol. 3: Roll 69, p. 34 |