| Regimental number | 7/1830 |
| Address | Rotherham |
| Marital status | Single |
| Next of kin | Father, J Clark, Rotherham, North Canterbury |
| Rank on embarkation | Trooper |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 8th Reinforcements, Canterbury Mounted Rifles Regiment |
| Embarkation details | Unit embarked from Wellington on board HMNZT 36 Tofua on |
| Miscellaneous details | Nominal Roll Vol. 1: Canterbury Mounted Rifles/Eighth |