| Regimental number | 68816 |
| Occupation | Sawmill hand |
| Next of kin | Wife, Mrs C Forman, Nydia Bay, Marlborough |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 36th Reinforcements, B Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT Willochra on |
| Sources | Nominal Rolls Vol. 4: Roll 81, p. 9 |