| Regimental number | 5/221 |
| Address | 25 Ferguson Street, Musselburgh, Dunedin |
| Marital status | Single |
| Next of kin | Father, John Couchman, 25 Ferguson Street, Musselburgh, Dunedin |
| Rank on embarkation | Private |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 4th Reinforcements, Army Service Corps |
| Miscellaneous details | Nominal Roll Vol. 1: Army Service Corps/Fourth |