| Regimental number | 663 |
| Place of birth | Darlington, Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Skipton, Victoria |
| Marital status | Married |
| Age at embarkation | 32 |
| Next of kin | Wife, Mrs Jane Clark, Skipton, Victoria |
| Enlistment date | 16 February 1917 |
| Rank on enlistment | Private |
| Unit name | Machine Gun Company 10, Reinforcement 11 |
| AWM Embarkation Roll number | 24/15/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A29 Suevic on 21 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Machine Gun Battalion |
| Fate | Returned to Australia 23 September 1918 |
