| Regimental number | 9/923 |
| Address | Inchclutha |
| Marital status | Single |
| Next of kin | Mother, Mrs H F Blatch, Linwood Station, Te Anau |
| Rank on embarkation | Trooper |
| 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 |