| Regimental number | 20250 |
| Occupation | Clerk |
| Next of kin | Mother, Mrs J T Simon, 16 Roy Street, Wellington South |
| Rank on embarkation | Lance Corporal |
| Unit name | New Zealand Expeditionary Force, New Zealand Rifle Brigade, 10th Reinforcements to 2nd Battalion, F Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT 61 Aparima on |
| Sources | Nominal Roll Vol. 2: Roll 38, p. 30 |