| Regimental number | 6/1773 |
| Address | 21 Wainui Street, Nelson |
| Marital status | Single |
| Next of kin | Mother, Mrs Jeanette Balon, 200 High Street, East Ham, London, England |
| Rank on embarkation | Private |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 4th Reinforcements, Canterbury Infantry Battalion |
| Embarkation details | Unit embarked from Wellington on board HMNZT 21 Willochra on |
| Miscellaneous details | Nominal Roll Vol. 1: Canterbury Infantry Batln/Fourth |