| Regimental number | 5417 |
| Place of birth | Courland Russia |
| Religion | Orthodox |
| Occupation | Amalgamator |
| Address | Fimiston Post Office, Boulder, Western Australia |
| Marital status | Single |
| Age at embarkation | 30 |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/28/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A60 Aeneas on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 51st Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
