| Regimental number | 3691 |
| Place of birth | Uralla New South Wales |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Uralba, Alstonville, New South Wales |
| Marital status | Married |
| Age at embarkation | 25 |
| Next of kin | Wife, Mrs Mabel Pearl Simpson, Uralba, Alstonville, New South Wales |
| Enlistment date | 16 October 1916 |
| Rank on enlistment | Private |
| Unit name | 4th Pioneer Battalion, Reinforcement 9 |
| AWM Embarkation Roll number | 14/16/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A33 Ayrshire on 24 January 1917 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
