| Regimental number | 45643 |
| Occupation | Mine manager |
| Next of kin | Uncle, Charles Collins, Waitekauri via Waikino |
| Rank on embarkation | Lieutenant |
| Enlistment status | Conscript |
| Unit name | New Zealand Expeditionary Force, New Zealand Engineers Tunnelling Company, 5th Reinforcements |
| Embarkation details | Unit embarked from Wellington on board HMNZT 84 Turakina on |
| Sources | Nominal Roll Vol. 3: Roll 62, p. 39 |