| Regimental number | 37168 |
| Place of birth | Bunbury, Western Australia |
| Religion | Church of England |
| Occupation | Farmer |
| Address | 22 Forrest Street, North Perth, Western Australia |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Father, Charles Stanley Clark, 22 Forrest Street, North Perth, Western Australia |
| Previous military service | 22nd AASC |
| Enlistment date | 30 August 1916 |
| Rank on enlistment | Gunner |
| Unit name | Field Artillery Brigade, Reinforcement 29 |
| AWM Embarkation Roll number | 13/128/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board A15 Port Sydney on 9 November 1917 |
| Rank from Nominal Roll | Gunner |
| Unit from Nominal Roll | Australian Base Depot |
| Fate | Returned to Australia 22 September 1919 |
