| Regimental number | 5468 |
| Place of birth | Milton New South Wales |
| Religion | Methodist |
| Occupation | Labourer |
| Address | Milla Milla via Malanda, Queensland |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs E Simmons, Brooklet Richmond River, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 12th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/29/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Hawkes Bay on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 12th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
