| Regimental number | 39645 |
| Occupation | Merchant |
| Next of kin | Father, Herman Van Staveren, 128 The Terrace, Wellington |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 22nd Reinforcements, F Company (Unattached) |
| Embarkation details | Unit embarked from Wellington on board HMNZT 77 Mokoia on |
| Sources | Nominal Roll Vol. 3: Roll 55, p. 20 |