| Regimental number | 1476 |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 31 Sandy Road, Seaforth, Liverpool, Lancashire, England |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Father, John Clark, 31 Sandy Road, Seaforth, Liverpool, New South Wales |
| Enlistment date | 30 July 1915 |
| Rank on enlistment | Private |
| Unit name | 2nd Light Horse Regiment, 11th Reinforcement |
| AWM Embarkation Roll number | 10/7/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A47 Mashobra on 4 October 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |