| Regimental number | 5505 |
| Place of birth | Samarkand Russia |
| Religion | Orthodox |
| Occupation | Clerk |
| Address | Hoey Bros, Brandon, Queensland |
| Marital status | Single |
| Age at embarkation | 31 |
| Next of kin | ..., PO Worker's Life, Box 10 Stanley Street, S, Brisbane, Queensland |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 12th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/29/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Hawkes Bay on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 12th Battalion |
| Fate | Discharged |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
