| Regimental number | 35004 |
| Occupation | Farmer |
| Next of kin | Mother, Mrs M A Coates, Greenfield, Otago |
| Rank on embarkation | Rifleman |
| Unit name | New Zealand Expeditionary Force, 20th Reinforcements (2nd Draft), New Zealand Rifle Brigade Details, J Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT Opawa on |
| Final rank | Private |
| Final unit | 3rd Battalion, Otago Infantry Regiment |
| Fate | Killed in Action |
| Age at death from cemetery records | 24 |
| Place of burial | Tyne Cot Cemetery (Plot XXV, Row C, Grave No 5), Zonnebeke, Belgium |
| Miscellaneous information from cemetery records | Parents: Samuel and Mary Ann Coates, 155 Evans Street, Timaru, New Zealand |
| Sources | Nominal Roll Vol. 2: Roll 49, p. 15 |