| Regimental number | 4999 |
| Place of birth | Geelong, Victoria |
| Religion | Presbyterian |
| Occupation | Farmer |
| Address | Yarrangundry, New South Wales |
| Marital status | Single |
| Age at embarkation | 39 |
| Next of kin | Father, William Clark, 'Braeside', Yarrangundry, New South Wales |
| Enlistment date | 19 February 1917 |
| Date of enlistment from Nominal Roll | 20 February 1917 |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 14th Reinforcement |
| AWM Embarkation Roll number | 23/47/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A74 Marathon on 10 May 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 30th Battalion |
| Fate | Returned to Australia 5 June 1919 |