| Regimental number | 75761 |
| Occupation | Labourer |
| Next of kin | Wife, Mrs H H Burgess, Rongotea |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 40th Reinforcements, B Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT No 107 Tahiti on |
| Sources | Nominal Rolls Vol. 4: Roll 86, p. 8 |