| Regimental number | 3623 |
| Place of birth | Melbourne, Victoria |
| Religion | Methodist |
| Occupation | Labourer |
| Address | Northcote, Victoria |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Father, J C Clark, 191 Raleigh Street, Northcote, Victoria |
| Enlistment date | 3 May 1917 |
| Rank on enlistment | Private |
| Unit name | 57th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/74/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on 28 February 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 57th Battalion |
| Fate | Returned to Australia 4 January 1919 |