| Regimental number | 10780 |
| Occupation | Carpenter |
| Next of kin | Father, C Clark, Grey Street, Devonport, Auckland |
| Rank on embarkation | Lance Corporal |
| Unit name | New Zealand Expeditionary Force, 12th Reinforcements (2nd Draft), 1st New Zealand Cyclist Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT 52 Mokoia on |
| Sources | Nominal Roll Vol. 2: Roll 31, p. 4 |