| Regimental number | 63011 |
| Occupation | Storeman |
| Next of kin | Wife, Mrs I Mitcham, c/o W A Young Sewell Street Kaiapoi |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 31st Reinforcements, Otago Infantry Regiment, D Company |
| Embarkation details | Unit embarked from Wellington on board Willochra on |
| Sources | Nominal Roll Vol. 3: Roll 75, p. 14 |