| Regimental number | 11/737 |
| Address | Seddon Street, Raetihi |
| Marital status | Single |
| Next of kin | H Bohlsen, 76 Bulwarra Road, Pyrmont, Sydney, New South Wales, Australia |
| Rank on embarkation | Sergeant |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 2nd Reinforcements, Wellington Mounted Rifles |
| Embarkation details | Unit embarked from Wellington on board Verdala on |
| Miscellaneous details | Nominal Roll Vol. 1: Wellington Mounted Rifles/Second |