| Regimental number | 3165 |
| Place of birth | Wells England |
| Religion | Methodist |
| Occupation | Farmer |
| Address | Young, New South Wales |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mother, Mrs Ellen Simmons, Priddy near Wells, Somerset, England |
| Enlistment date | 17 February 1917 |
| Rank on enlistment | Private |
| Unit name | April 1917 Reinforcements |
| AWM Embarkation Roll number | 11/14/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A15 Port Sydney on 9 May 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 15th Light Horse Regiment |
| Fate | Returned to Australia 23 July 1919 |
