| Regimental number | 10/1352 |
| Address | Taranaki |
| Marital status | Single |
| Next of kin | Mother, Mrs Elizabeth Jane Theobald, Eltham |
| Rank on embarkation | Private |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 2nd Reinforcements, Wellington Infantry Battalion |
| Embarkation details | Unit embarked from Wellington on board Willochra on |
| Miscellaneous details | Nominal Roll Vol. 1: Wellington Infantry Batln/Second |