| Regimental number | 5/204 |
| Occupation | Miner |
| Next of kin | Wife, Mrs Henchen Rasmussen, 125 Tainui Street, Greymouth |
| Rank on embarkation | Rifleman |
| Unit name | New Zealand Expeditionary Force, New Zealand Rifle Brigade Reinforcements, H Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT Navua on |
| Other details | Ex Samoan Relief |
| Sources | Nominal Roll Vol. 3: Roll 55, p. 33 |