| Regimental number | 12963 |
| Occupation | Labourer |
| Next of kin | Mother, Mrs J Anderson, Green Hills, Southland |
| Rank on embarkation | Rifleman |
| Unit name | New Zealand Expeditionary Force, New Zealand Rifle Brigade, 3rd Reinforcements to 4th Battalion, H Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT 53 Navua on |
| Sources | Nominal Roll Vol. 2: Roll 31, p. 23 |