| Regimental number | 69064 |
| Place of birth | Jung Victoria |
| Religion | Methodist |
| Occupation | Moulder |
| Address | 15 Crimea Street, Burnley, Victoria |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs F Mitchek, 15 Crimea Street, Burnley, Victoria |
| Enlistment date | 15 July 1918 |
| Rank on enlistment | Private |
| Unit name | 16th General (Victorian) Reinforcements |
| AWM Embarkation Roll number | 23/111/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Carpentaria on 7 November 1918 |
| Fate | No details of fate entered on Nominal Roll |
