| Regimental number | 1642 |
| Place of birth | Geelong Victoria |
| Religion | Presbyterian |
| Occupation | Labourer |
| Address | A. Simonsen, River Terrace, Ascot Vale, Victoria |
| Marital status | Single |
| Age at embarkation | 31 |
| Next of kin | Father, A. Simonsen, River Terrace, Ascot Vale, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 4th Light Horse Regiment, 12th Reinforcement |
| AWM Embarkation Roll number | 10/9/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A40 Ceramic on |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 13th Light Horse Regiment |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
