| Regimental number | 3416 |
| Place of birth | London England |
| Religion | Roman Catholic |
| Occupation | Sawyer |
| Address | Eildon Road, Windsor, Brisbane, Queensland |
| Marital status | Married |
| Age at embarkation | 41 |
| Next of kin | Wife, Mrs Ellen Clark, Eildon Road, Windsor, Brisbane, Queensland |
| Enlistment date | 5 January 1917 |
| Rank on enlistment | Private |
| Unit name | 52nd Battalion 9th Reinforcement |
| AWM Embarkation Roll number | 23/69/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A33 Ayrshire on 24 January 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 52nd Battalion |
| Fate | Returned to Australia 26 September 1917 |
