| Regimental number | 4475 |
| Place of birth | Kerswick Victoria |
| Religion | Methodist |
| Occupation | Labourer |
| Address | Narrogin, Western Australia |
| Marital status | Single |
| Age at embarkation | 35 |
| Next of kin | Father, E Simons, Newtown, Geelong, Victoria |
| Enlistment date | 23 February 1916 |
| Rank on enlistment | Sapper |
| Unit name | No 6 Tunnelling Company |
| AWM Embarkation Roll number | 16/12/1 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A69 Warilda on 1 June 1916 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 3rd Tunnelling Company |
| Fate | Returned to Australia 27 July 1917 |