| Regimental number | 6095 |
| Place of birth | Stawell, Victoria |
| Religion | Church of England |
| Occupation | Horse driver |
| Address | Robert Street, Kalgoorlie, Western Australia |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mother, Mrs M Clark, Robert Street, Kalgoorlie, Western Australia |
| Enlistment date | 3 February 1915 |
| Rank on enlistment | Driver |
| Unit name | Infantry Brigade 5, 15th Company, Army Service Corps |
| AWM Embarkation Roll number | 25/103/1 |
| Embarkation details | Unit embarked from |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
