| Regimental number | 16/258 |
| Address | Otaki |
| Marital status | Single |
| Next of kin | Mrs Elizabeth Cootes, Otaki |
| Rank on embarkation | Private |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 1st Maori Contingent, A Company |
| Embarkation details | Unit embarked from Wellington on board HMNZT 20 Warrimoo on |
| Miscellaneous details | Nominal Roll Vol. 1: A Company/First Maori |