| Regimental number | 6564 |
| Place of birth | Forster New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Forster, New South Wales |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Father, G Simon, Forster PO, Forster, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 20th Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/37/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A68 Anchises on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 20th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
