| Regimental number | 14163 |
| Occupation | Labourer |
| Next of kin | Wife, Mrs Mabel Payne Shellam, 3 Russell Street, Ponsonby, Auckland |
| Rank on embarkation | Rifleman |
| Unit name | New Zealand Expeditionary Force, New Zealand Rifle Brigade, 5th Reinforcements to 3rd Battalion, G Company (Unattached) |
| Embarkation details | Unit embarked from Wellington on |
| Medals |
Croix de Guerre (France) 'For distinguished services rendered during the course of the campaign.'
Source: London Gazette Date: |
| Sources | Nominal Roll Vol. 2: Roll 34, p. 36 |