| Regimental number | 15/21 |
| Address | Wellington |
| Marital status | Single |
| Next of kin | Mrs Cunliffe Shawe, Barton-under-Needwood Burton-on-Trent England |
| Rank on embarkation | Major |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, Main Body, Headquarters |
| Embarkation details | Unit embarked from Wellington on board Maunganui on |
| Miscellaneous details | Nominal Roll Vol. 1: Headquarters/Main Body |