| Regimental number | 3/1717 |
| Occupation | Clerk |
| Next of kin | Mother, Mrs M J Peterson, corner of Coutts and Salek Streets, Kilbirnie, Wellington |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, New Zealand Rifle Brigade, No 2 Field Ambulance |
| Embarkation details | Unit embarked from Wellington on |
| Sources | Nominal Roll Vol. 2: Roll 24, p. 36 |