| Regimental number | 5/286 |
| Address | Hawera, Taranaki |
| Marital status | Single |
| Next of kin | Mother, Mrs Rose Roberts, Wadestown, Wellington |
| Rank on embarkation | Driver |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 4th Reinforcements, Army Service Corps |
| Miscellaneous details | Nominal Roll Vol. 1: Army Service Corps/Fourth |