| Regimental number | 28976 |
| Occupation | Labourer |
| Next of kin | Mother, Mrs J Clark, 123 Harper Street, Christchurch |
| Rank on embarkation | Rifleman |
| Unit name | New Zealand Expeditionary Force, New Zealand Rifle Brigade, 9th Reinforcements to 3rd Battalion, G Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT 66 Willochra on |
| Sources | Nominal Roll Vol. 2: Roll 43, p. 30 |