| Regimental number | 11004 |
| Occupation | Labourer |
| Next of kin | Aunt, Miss A McLeay, Beach Road, Thames |
| Rank on embarkation | Rifleman |
| Unit name | New Zealand Expeditionary Force, New Zealand Rifle Brigade, 6th Reinforcements to 1st Battalion, E Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT 51 Ulimaroa on |
| Sources | Nominal Roll Vol. 2: Roll 30, p. 18 |