| Regimental number | 770 |
| Place of birth | Vilno Russia |
| Religion | Protestant |
| Occupation | Tailor |
| Marital status | Married |
| Age at embarkation | 41 |
| Next of kin | Wife, Mrs Elizabeth Urniarz, Muangor, Carrington Street, Randwick, New South Wales |
| Enlistment date | 5 October 1914 |
| Date of enlistment from Nominal Roll | 8 October 1914 |
| Rank on enlistment | Private |
| Unit name | Australian General Hospital 2 |
| AWM Embarkation Roll number | 26/66/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board Transport A55 Kyarra on 28 November 1914 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | No 2 Australian General Hospital |
| Fate | Returned to Australia 4 June 1919 |
