| Regimental number | 11/769 |
| Address | Lake Station, Waipukurau |
| Marital status | Single |
| Next of kin | Mrs J E Green, Waipukurau |
| Rank on embarkation | Trooper |
| Enlistment status | Volunteer |
| Unit name | New Zealand Expeditionary Force, 2nd Reinforcements, Wellington Mounted Rifles |
| Embarkation details | Unit embarked from Wellington on board Verdala on |
| Miscellaneous details | Nominal Roll Vol. 1: Wellington Mounted Rifles/Second |