| Regimental number | 11008 |
| Occupation | Bushman |
| Next of kin | Mother, Mrs M Perry, Church Street, Kaikorai, Otago |
| 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 |