| Regimental number | 21953 |
| Occupation | Striker |
| Next of kin | Wife, Mrs A L Annan, 57A Macandrew Road, South Dunedin |
| Rank on embarkation | Corporal |
| Unit name | New Zealand Expeditionary Force, 16th Reinforcements, Otago Infantry Battalion, D Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT 63 Navua on |
| Sources | Nominal Roll Vol. 2: Roll 38, p. 16 |