| Regimental number | 36364 |
| Occupation | Wireworker |
| Next of kin | Mother, Mrs P Sampson, 215 Stanmore Road, Richmond, 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 |