| Regimental number | 36363 |
| Occupation | Shop assistant |
| Next of kin | Wife, Mrs A M Sampson, 25 Montreal Street, Sydenham, Christchurch |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 21st Reinforcements, Canterbury Infantry Battalion, C Company |
| Embarkation details | Unit embarked from Wellington on board Ulimaroa on |
| Sources | Nominal Roll Vol. 3: Roll 52, p. 13 |