| Regimental number | 4405 |
| Religion | Roman Catholic |
| Occupation | Mechanic |
| Address | Seamen's Mission Home, George Street, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Sister, Mrs Venel Zaxmon, Dubehskabo Venda Pohta Vavkovyky, Selo Ulbarol, Russia |
| Enlistment date | 18 October 1916 |
| Rank on enlistment | Private |
| Unit name | 29th Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/46/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A19 Afric on 3 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 29th Battalion |
| Fate | Returned to Australia 10 January 1918 |
