| Regimental number | 9/991 |
| Address | Masterton, Wairarapa |
| Marital status | Single |
| Next of kin | Sister, Miss E Adcock, 57 Catlin Street, Rotherhithe New Road, Bermondsey, London, England |
| Rank on embarkation | Trooper |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 4th Reinforcements, Canterbury Mounted Rifles |
| Embarkation details | Unit embarked from Wellington on board HMNZT 23 Waitomo on |
| Miscellaneous details | Nominal Roll Vol. 1: Canterbury Mounted Rifles/Fourth |