| Regimental number | 594 |
| Place of birth | Plymouth England |
| Religion | Church of England |
| Occupation | Sailor |
| Address | No fixed address |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Mother, Mrs Mary Simons, 38 Dunn Street, Hackney, London, England |
| Enlistment date | 26 January 1917 |
| Rank on enlistment | Private |
| Unit name | Machine Gun Company 10, Reinforcement 9 |
| AWM Embarkation Roll number | 24/15/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A11 Ascanius on 11 May 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Machine Gun Battalion |
| Fate | Returned to Australia 15 September 1918 |
