| Regimental number | 10781 |
| Occupation | Optician |
| Next of kin | Mother, Mrs M E Clark, 172 Bealey Avenue, Christchurch |
| Rank on embarkation | Private |
| 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 |