| Regimental number | 63856 |
| Occupation | Labourer |
| Next of kin | Mother, Mrs C Gjersen, 17 Aurora Street, Petone |
| Rank on embarkation | Corporal |
| Unit name | New Zealand Expeditionary Force, 40th Reinforcements, B Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT No 107 Tahiti on |
| Sources | Nominal Rolls Vol. 4: Roll 86, p. 7 |