| Regimental number | 21496 |
| Occupation | Butcher |
| Next of kin | Mother, Mrs J B Cook, Rangiahua, Hokianga |
| Rank on embarkation | Rifleman |
| Unit name | New Zealand Expeditionary Force, New Zealand Rifle Brigade, 7th Reinforcements to 4th Battalion, H Company |
| Embarkation details | Unit embarked from Wellington on board Navua on |
| Sources | Nominal Roll Vol. 2: Roll 38, p. 37 |