| Regimental number | 7965 |
| Place of birth | Cornwall England |
| Religion | No religion |
| Occupation | Pipe layer |
| Address | Clarence Park, South Australia |
| Marital status | Married |
| Age at embarkation | 40 |
| Next of kin | Wife, Mrs A I M Simons, Frederick Street, Clarence Park, South Australia |
| Enlistment date | 30 July 1917 |
| Rank on enlistment | Sapper |
| Unit name | Tunnelling Companies (Sept 1916 - Feb 1918 Reinf) |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on 21 November 1917 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 2nd Tunnelling Company |
| Fate | Returned to Australia 24 July 1919 |
