| Regimental number | 11/1964 |
| Address | 223 Rintoul Street, Wellington |
| Marital status | Single |
| Next of kin | Mother, Mrs M Scott, 223 Rintoul Street, Wellington |
| Rank on embarkation | Trooper |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 8th Reinforcements, Wellington Mounted Rifles |
| Embarkation details | Unit embarked from Wellington on board Tofua on |
| Miscellaneous details | Nominal Roll Vol. 1: Wellington Mounted Rifles/Eighth |