| Regimental number | 9/793 |
| Address | Hanover Street, Dunedin |
| Marital status | Married |
| Next of kin | Wife, Mrs A C Black, 8 Hanover Street, Dunedin |
| Rank on embarkation | Quartermaster Sergeant |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 3rd Reinforcements, Otago Mounted Rifles |
| Embarkation details | Unit embarked from Wellington on board Aparima on |
| Miscellaneous details | Nominal Roll Vol. 1: Otago Mounted Rifles/Third |