| Regimental number | 63678 |
| Occupation | Labourer |
| Next of kin | Mother, Mrs Jane Sampson, 25 Fitzherbert Street, Petone |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 32nd Reinforcements, F Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT 96 Maunganui on |
| Sources | Nominal Roll Vol. 3: Roll 75, p. 42 |