| Regimental number | 7/812 |
| Address | Waihongi, Puketi |
| Marital status | Single |
| Next of kin | Mother, Mrs Ella Michie, Okaihau, Bay of Islands |
| Rank on embarkation | Trooper |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 3rd Reinforcements, Canterbury Mounted Rifles |
| Embarkation details | Unit embarked from Wellington on board HMNZT 19 Apimara on |
| Miscellaneous details | Nominal Roll Vol. 1: Canterbury Mounted Rifles/Third |