| Regimental number | 11/1108 |
| Address | Pukearuhe, Waitara |
| Marital status | Married |
| Next of kin | Wife, Mrs C E Davis, Waverley, Taranaki |
| Rank on embarkation | Sergeant |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 5th Reinforcements, Wellington Mounted Rifles |
| Embarkation details | Unit embarked from Wellington on board Tahiti on |
| Miscellaneous details | Nominal Roll Vol. 1: Wellington Mounted Rifles/Fifth |