| Regimental number | 30216 |
| Occupation | Bushman |
| Next of kin | Mother, Mrs S Hayes, Liverpool Street, Auckland |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 20th Reinforcements (2nd Draft), F Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT Athenic on |
| Sources | Nominal Roll Vol. 2: Roll 49, p. 10 |