| Regimental number | 69876 |
| Place of birth | Australia |
| Occupation | Cook |
| Next of kin | Mother, Mrs J Payne, Glenorchy, Victoria, Australia |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 40th Reinforcements, E Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT 107 Tahiti on |
| Sources | Nominal Rolls Vol. 4: Roll 86, p. 16 |