| Regimental number | 11/1091 |
| Address | Mangatokerau, Tolaga Bay |
| Marital status | Single |
| Next of kin | Mother, Mrs Effie Willis, 62 Tainui Terrace, Lyall Bay, Wellington |
| Rank on embarkation | Corporal |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 4th Reinforcements, Wellington Mounted Rifles |
| Embarkation details | Unit embarked from Wellington on board Waitomo on |
| Miscellaneous details | Nominal Roll Vol. 1: Wellington Mounted Rifles/Fourth |