| Regimental number | 10111 |
| Other Names | Jack |
| Religion | Orthodox |
| Occupation | Electrician |
| Address | Queanbeyan, New South Wales |
| Marital status | Single |
| Age at embarkation | 33 |
| Next of kin | Mother, Mrs J Taylor, McCauley Street, Queanbeyan, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Dermatological Hospital, 4th Reinforcement |
| AWM Embarkation Roll number | 26/103/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A71 Nestor on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Field Ambulance |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
