| Regimental number | 4292 |
| Place of birth | Lismore New South Wales |
| Religion | Church of England |
| Occupation | Carpenter |
| Address | 39 Hart Street, Tempe, New South Wales |
| Marital status | Married |
| Age at embarkation | 30 |
| Next of kin | Wife, Mrs Violet Simmonds, 39 Hart Street, Tempe, New South Wales |
| Enlistment date | 5 June 1916 |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/47/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Port Nicholson on 8 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 30th Battalion |
| Fate | Returned to Australia 6 June 1918 |
