| Regimental number | 78612 |
| Occupation | Farm labourer |
| Next of kin | Mother, Mrs D W Clark, Rock Ford, via Oxford, Canterbury |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 40th Reinforcements, A Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT No 107 Tahiti on |
| Sources | Nominal Rolls Vol. 4: Roll 86, p. 4 |