| Regimental number | 20941 |
| Place of birth | Ballarat, Victoria |
| Religion | Presbyterian |
| Occupation | Student |
| Address | 653 Sydney Road, Brunswick, Victoria |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs Minnie Clark, 653 Sydney Road, Brunswick, Victoria |
| Enlistment date | 10 August 1917 |
| Rank on enlistment | Sapper |
| Unit name | |
| AWM Embarkation Roll number | 22/15/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on 21 November 1917 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
