| Regimental number | 39763 |
| Occupation | Clerk |
| Next of kin | Mother, Mrs Jeanett Collins, 35 Pullen Street, Grey Lynn, Auckland |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 22nd Reinforcements, Wellington Infantry Regiment, B Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT Aparima on |
| Sources | Nominal Roll Vol. 3: Roll 55, p. 7 |