| Regimental number | 62916 |
| Occupation | Farm hand |
| Next of kin | Mother, Mrs A E Bradshaw, 22 Farley Street, Kaikorai, Dunedin |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 30th Reinforcements, Otago Infantry Company, D Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT No 93 Corinthic on |
| Sources | Nominal Roll Vol. 3: Roll 72, p. 14 |