| Regimental number | 58841 |
| Place of birth | Australia |
| Occupation | Carpenter |
| Next of kin | Mother, Mrs Lillie Black, 22 Cutten Street, St Kilda, Dunedin |
| Rank on embarkation | Lance Corporal |
| Unit name | New Zealand Expeditionary Force, 29th Reinforcements, Otago Infantry Regiment, D Company |
| Embarkation details | Unit embarked from Wellington, New Zealand, on board SS Ruahine on |
| Sources | Nominal Roll Vol. 3: Roll 70, p. 13 |