| Regimental number | 5763 |
| Place of birth | Samara Russia |
| Religion | Orthodox |
| Occupation | Railway labourer |
| Address | Rockhampton, Queensland |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Sister, Miss A Tupicoff, PO Perekopnoe Samara, Russia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 15th Battalion, 18th Reinforcement |
| AWM Embarkation Roll number | 23/32/2 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A49 Seang Choon on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 42nd Battalion |
| Fate | Returned to Australia |
| Date of death | |
| Place of burial | Mt Thompson Crematorium |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
