| Regimental number | 58933 |
| Occupation | Fireman |
| Next of kin | Mother, Mrs Jessie Shaw, 432A George Street, Dunedin |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 29th Reinforcements, Otago Infantry Regiment, D Company |
| Embarkation details | Unit embarked from Wellington, New Zealand, on board SS Ruahine on |
| Sources | Nominal Roll Vol. 3: Roll 70, p. 15 |