| Regimental number | 13/769 |
| Address | Ohakune |
| Marital status | Single |
| Next of kin | Mother, Mrs C M Adam, Ladies Nurse, 3 Bolton Terrace, Wellington |
| Rank on embarkation | Trooper |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 3rd Reinforcements, Auckland Mounted Rifles |
| Embarkation details | Unit embarked from Wellington on board Tahiti on |
| Miscellaneous details | Nominal Roll Vol. 1: Auckland Mounted Rifles/Third |