| Regimental number | 371 |
| Place of birth | West Maitland New South Wales |
| Religion | Methodist |
| Occupation | Groom |
| Address | Kurri Kurri, New South Wales |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs M A Clack, Hopetoun Street, Kurri Kurri, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 34th Battalion, B Company |
| AWM Embarkation Roll number | 23/51/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A20 Hororata on |