| Regimental number | 78621 |
| Place of birth | Australia |
| Occupation | Labourer |
| Next of kin | Brother, W Park, Yarraville, Victoria, Australia |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 40th Reinforcements, A Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT No 107 Tahiti on |
| Sources | Nominal Rolls Vol. 4: Roll 86, p. 6 |