| Regimental number | 10764 |
| Occupation | Labourer |
| Next of kin | Mother, Mrs W Bradley, Mangapiri Post Office, Southland |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 12th Reinforcements (2nd Draft), Wellington Infantry Battalion, J Company |
| Embarkation details | Unit embarked from Wellington on board Mokoia on |
| Sources | Nominal Roll Vol. 2: Roll 31, p. 8 |