| Regimental number | 76752 |
| Occupation | Ship provider |
| Next of kin | Friend, R Blackburn, St John's Street, Wanganui |
| 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 |