| Regimental number | 30699 |
| Occupation | Bootmaker |
| Next of kin | Wife, Mrs E A F Grey, 43 St Hill Street, Wanganui |
| Rank on embarkation | Private |
| Unit name | Miscellaneous Embarkations, Samoan Relief |
| Embarkation details | Unit embarked from New Zealand on board SS Talune on |
| Sources | Nominal Rolls Vol. 4: Roll 82, p. 24 |