| Regimental number | 11/19 |
| Address | 48 Taranaki Street, Palmerston North |
| Marital status | Married |
| Next of kin | Wife, Mrs Ruby Evelyn Burns, Palmer's Empire Hotel' Petone |
| Rank on embarkation | Trooper |
| 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 |