| Regimental number | 12563 |
| Occupation | Farmer |
| Next of kin | Father, M Burgess, 43 Heads Road, Wanganui |
| Rank on embarkation | Corporal |
| Unit name | New Zealand Expeditionary Force, 12th Reinforcements (2nd Draft), New Zealand Mounted Rifles Brigade |
| Embarkation details | Unit embarked from Wellington on |
| Sources | Nominal Roll Vol. 2: Roll 31, p. 2 |