| Regimental number | 4363 |
| Place of birth | Launceston, Tasmania |
| Religion | Methodist |
| Occupation | Farmer |
| Address | Burnie, Tasmania |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Father, A Chalk, Burnie, Tasmania |
| Enlistment date | 19 July 1915 |
| Rank on enlistment | Private |
| Unit name | 15th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/32/2 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A55 Kyarra on 3 January 1916 |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 15th Battalion |
| Fate | Returned to Australia 5 March 1919 |
