| Regimental number | 31058 |
| Occupation | Telegraph lineman |
| Next of kin | Wife, Mrs C F Ammon, GPO, Wellington |
| Rank on embarkation | Trooper |
| Unit name | New Zealand Expeditionary Force, 21sr Reinforcements, Mounted Rifles Brigade |
| Embarkation details | Unit embarked from Wellington on board Manuka on |
| Sources | Nominal Roll Vol. 3: Roll 53, p. 1 |