| Regimental number | 3504 |
| Place of birth | Melbourne, Victoria |
| Religion | Church of England |
| Occupation | Collar cutter |
| Address | West Brunswick, Ivc |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs E E Clark, 186 Brunswick Road, West Brunswick, Victoria |
| Enlistment date | 30 October 1915 |
| Rank on enlistment | Private |
| Unit name | 20th Battalion, 8th Reinforcement |
| AWM Embarkation Roll number | 23/37/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A60 Aeneas on 20 December 1915 |
| Rank from Nominal Roll | Sergeant |
| Unit from Nominal Roll | 56th Battalion |
| Fate | Returned to Australia 25 September 1919 |
