| Regimental number | 1107 |
| Place of birth | Stawell, Victoria |
| Religion | Protestant |
| Occupation | Farmer |
| Address | Callawadda via Stawell, Victoria |
| Marital status | Single |
| Age at embarkation | 38 |
| Next of kin | Father, Robert Clark, Callawadda via Stawell, Victoria |
| Enlistment date | 23 April 1915 |
| Rank on enlistment | Private |
| Unit name | 5th Light Horse Regiment, 7th Reinforcement |
| AWM Embarkation Roll number | 10/10/2 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A9 Shropshire on 20 August 1915 |
| Rank from Nominal Roll | Trooper |
| Unit from Nominal Roll | 5th Light Horse Regiment |
| Fate | Returned to Australia 17 July 1919 |
