| Regimental number | 17266 |
| Place of birth | Lismore New South Wales |
| Religion | Orthodox |
| Occupation | Labourer |
| Address | 86 Hereford Street, Forest Lodge, Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 24 |
| Next of kin | Wife, Mrs Stella Pearl Bolewski, 86 Hereford Street, Forest Lodge, Sydney, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 1st Light Horse Field Ambulance, 27th Reinforcement |
| AWM Embarkation Roll number | 26/39/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A15 Port Sydney on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 8th Sanitation Section |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
