| Regimental number | 41030 |
| Occupation | Farmer |
| Next of kin | Mother, Mrs J Sim, Mure Street, Mosgiel |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 23rd Reinforcements, Otago Infantry Regiment, D Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT Ruapehu on |
| Sources | Nominal Roll Vol. 3: Roll 57, p. 15 |