| Regimental number | 10/3565 |
| Occupation | Bushman |
| Next of kin | Mother, Mrs M Goater, Park Row, Nottingham, England |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 9th Reinforcements, Wellington Infantry Battalion, B Company |
| Embarkation details | Unit embarked from Wellington on board SS Maunganui on |
| Sources | Nominal Roll Vol. 2: Roll 21, p. 20 |