| Regimental number | 5923 |
| Place of birth | South Melbourne Victoria |
| Religion | Methodist |
| Occupation | Coal miner |
| Address | Collie, Western Australia |
| Marital status | Single |
| Age at embarkation | 33 |
| Next of kin | Mother, Mrs Nelson Simmonds, Collie, Cardiff, Western Australia |
| Enlistment date | 30 May 1916 |
| Rank on enlistment | Private |
| Unit name | 27th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/44/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A16 Port Melbourne on 30 October 1916 |
| Regimental number from Nominal Roll | 5923A |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 28th Battalion |
| Fate | Returned to Australia 23 July 1919 |