| Regimental number | 30400 |
| Occupation | Farm hand |
| Next of kin | Father, A Payne, 66 Victoria Street, Hawera |
| Rank on embarkation | Rifleman |
| Unit name | New Zealand Expeditionary Force, New Zealand Rifle Brigade, 4th Battalion, 11th Reinforcements, H Company |
| Embarkation details | Unit embarked from Wellington on board Port Lyttelton on |
| Harbour records indicate that the actual date of sailing was 8 December 1916. | |
| Sources | Nominal Roll Vol. 2: Roll 47, p. 12 |