| Regimental number | 412 |
| Place of birth | Russia |
| Religion | Roman Catholic |
| Occupation | Bootmaker |
| Marital status | Single |
| Age at embarkation | 23 |
| Height | 5' 3" |
| Weight | 130 lbs |
| Next of kin | Father, George Cepkouski, Avaleski, Russian Poland |
| Previous military service | Nil |
| Enlistment date | |
| Place of enlistment | Helena Vale, Western Australia |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, C Company |
| AWM Embarkation Roll number | 23/33/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A40 Ceramic on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 6th Battalion |
| Fate | Returned to Australia |
| Miscellaneous details (Nominal Roll) | Surname incorrectly entered on Nominal Roll as CEPKONSKI. |
| Discharge date | |
| Other details |
War service: no details on Form B103. Commenced return to Australia, 2 July 1915; discharged (medically unfit), Perth, 17 December 1915. Medals: 1914-15 Star, British War Medal, Victory Medal |
| Miscellaneous details | Surname entered incorrectly on Embarkation Roll as CEPKONSKI. |