| Regimental number | 17723 |
| Place of birth | Melbourne, Victoria |
| Religion | Brethren |
| Occupation | Moulder |
| Address | Claremont, Western Australia |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Father, R D Clark, Loftus Street, Claremont, Western Australia |
| Enlistment date | 17 July 1916 |
| Rank on enlistment | Private |
| Unit name | April 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 1 August 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 14th Field Ambulance |
| Fate | Returned to Australia 19 April 1919 |
