| Regimental number | 9/1360 |
| Address | c/o W Gardena, Papakaio |
| Marital status | Single |
| Next of kin | Mother, Mrs J Surtalla, Allanton, Otago |
| Rank on embarkation | Trooper |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 6th Special Squadron |
| Embarkation details | Unit embarked from Wellington on |
| Miscellaneous details | Nominal Roll Vol. 1: Special Squadrons/Sixth |