| Regimental number | 11/747 |
| Address | 9 Kensington Street, Wellington |
| Marital status | Single |
| Next of kin | Fawcett Cave, 447 Lord Street, Southport, England |
| 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 |