| Regimental number | 13403 |
| Place of birth | Unley, South Australia |
| Religion | Church of England |
| Occupation | Bootmaker |
| Address | Glenelg, South Australia |
| Marital status | Single |
| Age at embarkation | 29 |
| Next of kin | Mother, Mrs B Clarke, Charlotte Place, Adelaide, South Australia |
| Enlistment date | |
| Place of enlistment | Adelaide, South Australia |
| Rank on enlistment | Private |
| Unit name | March 1916 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A61 Kanowna on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Field Ambulance |
| Fate | Returned to Australia |
| Other details |
War service: Western Front Medals: British War Medal, Victory Medal |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
