| Regimental number | 11/874 |
| Address | Sam Brewer, Makahu, Taranaki |
| Marital status | Married |
| Next of kin | Wife, Mrs Theresa J F Foley, Victoria Road, Stratford |
| Rank on embarkation | Trooper |
| 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 |