| Regimental number | 14076 |
| Occupation | Fruiterer |
| Next of kin | Wife, Mrs Grace Ethel Cousins, 49 Great North Road, Auckland |
| Rank on embarkation | Rifleman |
| Unit name | New Zealand Expeditionary Force, New Zealand Rifle Brigade, 5th Reinforcements to 3rd Battalion, G Company (Unattached) |
| Embarkation details | Unit embarked from Wellington on |
| Sources | Nominal Roll Vol. 2: Roll 34, p. 35 |