| Regimental number | 284 |
| Place of birth | Kent England |
| Religion | Church of England |
| Occupation | Council clerk |
| Address | West Burleigh, SC Line, Queensland |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Mother, Mrs Maude L Clark, 111 London Road, Twickenham, Middlesex, England |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Machine Gun Company 12, Reinforcement 3 |
| AWM Embarkation Roll number | 24/17/3 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A46 Clan Macgillivray on |
| Rank from Nominal Roll | Sergeant |
| Unit from Nominal Roll | 4th Machine Gun Battalion |
| Recommendations (Medals and Awards) |
Mention in Despatches Not awarded. Recommendation date: |
| Fate | Effective abroad (still overseas) |