| Regimental number | 5450 |
| Religion | Methodist |
| Occupation | Leather |
| Address | 384 Canning Street, North Carlton, Victoria |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Father, Mr F C Simmons, 384 Canning Street, North Carlton, Victoria |
| Enlistment date | 3 February 1916 |
| Rank on enlistment | Private |
| Unit name | 8th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/25/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A14 Euripides on 4 April 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
