| Regimental number | 2264 |
| Place of birth | Tiburton Victoria |
| Religion | Roman Catholic |
| Occupation | Station hand |
| Address | 437 Toorak Road, Toorak, Victoria |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs Mary Nowotna, c/o Dr McDonald, 437 Toorak Road, Toorak, Victoria |
| Enlistment date | 28 March 1916 |
| Rank on enlistment | Private |
| Unit name | 58th Battalion, 4th Reinforcement |
| AWM Embarkation Roll number | 23/75/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A67 Orsova on 1 August 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 6th Depot Unit of Supply |
| Fate | Returned to Australia 9 July 1919 |
