| Regimental number | 65621 |
| Occupation | Farmer |
| Next of kin | Wife, Mrs Agnes May Carlson, Hunter Road Eltham |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 36th Reinforcements, A Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT Willochra on |
| Sources | Nominal Rolls Vol. 4: Roll 81, p. 4 |