| Regimental number | 10/3843 |
| Occupation | Bushman |
| Next of kin | Father, A Pelvin, Mill Road, Waimate, Canterbury |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 10th Reinforcements, Wellington Infantry Battalion, B Company |
| Embarkation details | Unit embarked from Wellington on |
| Sources | Nominal Roll Vol. 2: Roll 26, p. 12 |