| Regimental number | 3122 |
| Place of birth | Stanley Victoria |
| Religion | Presbyterian |
| Occupation | Miner |
| Address | Stanley PO, Stanley, Victoria |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Father, Simon Malsem, Deep Creek near Beechworth, Victoria |
| Enlistment date | 23 October 1916 |
| Date of enlistment from Nominal Roll | 9 October 1916 |
| Rank on enlistment | Private |
| Unit name | 8th Light Horse Regiment, 24th Reinforcement |
| AWM Embarkation Roll number | 10/13/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A25 Anglo-Egyptian on 31 January 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 8th Light Horse Regiment |
| Fate | Returned to Australia 3 July 1919 |
