| Regimental number | 3126 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Clerk |
| Address | 5 Moorhead Street, Redfern, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Father, D Simmons, 5 Moorhead Street, Redfern, Sydney, New South Wales |
| Enlistment date | 2 September 1915 |
| Rank on enlistment | Private |
| Unit name | 3rd Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/20/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A69 Warilda on 8 October 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | v5 ATM Battery |
| Fate | Returned to Australia 13 February 1917 |
