| Regimental number | 2494 |
| Place of birth | Ballarat, Victoria |
| Religion | Church of England |
| Occupation | Grocer |
| Address | 11 Bowen Street, East Prahran, Victoria |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs Amelia Clack, 11 Bowen Street, East Prahran, Victoria |
| Enlistment date | 13 July 1915 |
| Rank on enlistment | Private |
| Unit name | 22nd Battalion, 5th Reinforcement |
| AWM Embarkation Roll number | 23/39/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Osterley on 29 September 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Corps Headquarters |
| Fate | Returned to Australia 11 May 1919 |
