| Regimental number | 73300 |
| Occupation | Bushman |
| Next of kin | Mother, Mrs S Bush, Fitzroy, Great Barrier Island |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 36th Reinforcements, B Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT Willochra on |
| Sources | Nominal Rolls Vol. 4: Roll 81, p. 8 |