| Regimental number | 9/1199 |
| Address | South Riverton |
| Marital status | Single |
| Next of kin | Mother, Mrs J McIntosh, South Riverton, Southland |
| Rank on embarkation | Trooper |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, Otago Mounted Rifles Regiment, 6th Reinforcement |
| Embarkation details | Unit embarked from Wellington on board HMNZT 28 Tofua on |
| Miscellaneous details | Nominal Roll Vol. 1: Otago Mounted Rifles/Sixth |