| Regimental number | 15491 |
| Occupation | Ploughman |
| Next of kin | Mother, Mrs A Clark, 248 Blenheim Road, Riccarton, Christchurch |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 15th Reinforcements (1st Draft), Canterbury Infantry Battalion, C Company |
| Embarkation details | Unit embarked from Wellington on board Waitemata on |
| Sources | Nominal Roll Vol. 2: Roll 37, p. 8 |