| Regimental number | 9/914 |
| Address | Montrose House, Rotorua |
| Marital status | Single |
| Next of kin | Mother, Mrs C Clifford, c/o Grand View Hotel, Rotorua |
| Rank on embarkation | Sergeant |
| 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 |