| Regimental number | 1170 |
| Place of birth | Gundagai New South Wales |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | Christina Balister, Temora, New South Wales |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs Christina Rollosen, Hoskens Street, Temora, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 12th Light Horse Regiment, 6th Reinforcement |
| AWM Embarkation Roll number | 10/17/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT SS Hawkes Bay on |
| Fate | No details of fate entered on Nominal Roll |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
