| Regimental number | 82628 |
| Occupation | Slaughterman |
| Next of kin | Wife, Mrs A E Burgess, 106 Bayview Road, South Dunedin |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 43rd Reinforcements (2nd Draft), B Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT 111 Matatua on |
| Sources | Nominal Rolls Vol. 4: Roll 90, p. 16 |