| Regimental number | 4/116A |
| Occupation | Seaman |
| Next of kin | Wife, Mrs E L O'Brien, 16 North Street, Tywardreath Par, Cornwall, England |
| Rank on embarkation | Sapper |
| Unit name | New Zealand Expeditionary Force, 15th Reinforcements (2nd Draft), New Zealand Engineers |
| Embarkation details | Unit embarked from Wellington on |
| Other details | Ex Main Body |
| Sources | Nominal Roll Vol. 2: Roll 37, p. 29 |