| Regimental number | 8/2538 |
| Address | Waikaka via Gore, Southland |
| Marital status | Single |
| Next of kin | Father, W Black, Waikaka via Gore, Southland |
| Rank on embarkation | Private |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 6th Reinforcement, Otago Infantry Battalion |
| Embarkation details | Unit embarked from Wellington on board Willochra on |
| Miscellaneous details | Nominal Roll Vol. 1: Otago Infantry Batln/Sixth |