| Regimental number | 3917 |
| Place of birth | Moravia Austria |
| Religion | Roman Catholic |
| Occupation | Farmer |
| Address | Deeford Gibson, Dawson, Valley Line, Queensland |
| Marital status | Single |
| Age at embarkation | 34 |
| Next of kin | Friend, Thomas Barton, Deeford Gibson, Dawson, Valley Line, Queensland |
| Enlistment date | 24 February 1917 |
| Rank on enlistment | Private |
| Unit name | 4th Pioneer Battalion, Reinforcement 10 |
| AWM Embarkation Roll number | 14/16/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A20 Hororata on 13 June 1917 |
| Regimental number from Nominal Roll | 3917A |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Machine Gun Battalion |
| Fate | Returned to Australia 25 March 1919 |
