| Regimental number | 9/905 |
| Address | Manuka Creek Lawrence |
| Marital status | Married |
| Next of kin | Wife, Mrs Adeline Julia Burnett, Manuka Creek near Lawrence |
| Rank on embarkation | Trooper |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 4th Reinforcements, Otago Mounted Rifles |
| Embarkation details | Unit embarked from Wellington on board Waitomo on |
| Miscellaneous details | Nominal Roll Vol. 1: Otago Mounted Rifles/Fourth |