| Regimental number | 2817 |
| Place of birth | Novoizihcoff, Russia |
| Religion | Church of England |
| Occupation | Miner |
| Address | Mount Morgan, Queensland |
| Marital status | Married |
| Age at embarkation | 26 |
| Next of kin | Wife, Mrs Akon Pehteroff, Chernigoff, Hotiwoka, Russia |
| Enlistment date | 14 August 1915 |
| Place of enlistment | Rockhampton, Queensland |
| Rank on enlistment | Private |
| Unit name | 25th Battalion, 6th Reinforcement |
| AWM Embarkation Roll number | 23/42/2 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A48 Seang Bee on 21 October 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
