| Regimental number | 4430 |
| Place of birth | Pernaw Russia |
| Religion | Methodist |
| Occupation | Storeman |
| Address | c/o Rev Reginald B Bowes, Parsonage, Botany, New South Wales |
| Marital status | Single |
| Age at embarkation | 29 |
| Next of kin | Aunt, I Bevolsky, 57 Millgaden, Riga, Russia |
| Enlistment date | 8 September 1915 |
| Rank on enlistment | Private |
| Unit name | 1st Battalion, 14th Reinforcement |
| AWM Embarkation Roll number | 23/18/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Osterley on 15 January 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Battalion |
| Fate | Effective abroad (still overseas) |
