| Regimental number | 66062 |
| Occupation | Farmer |
| Next of kin | Brother, G R Burgess, Arapohue |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 34th Reinforcements, New Zealand Medical Corps |
| Embarkation details | Unit embarked from Wellington on board HMNZT 100 Ulimaroa on |
| Sources | Nominal Rolls Vol. 4: Roll 78, p. 19 |