| Regimental number | 4249 |
| Place of birth | Prahran Victoria |
| Occupation | Fa |
| Address | 9/8/15 |
| Marital status | RC |
| Age at embarkation | 21 |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 14th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/31/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A64 Demosthenes on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 14th Battalion |
| Fate | Returned to Australia |