| Regimental number | 2040 |
| Place of birth | Melbourne, Victoria |
| Religion | Church of England |
| Occupation | Clerk |
| Address | 52 Kent Street, Ascot Vale, Victoria |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Father, Peter Clark, 52 Kent Street, Ascot Vale, Victoria |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 2nd Field Ambulance, Reinforcement 1 |
| AWM Embarkation Roll number | 26/45/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A35 Berrima on |
| Regimental number from Nominal Roll | 267 |
| Rank from Nominal Roll | Sergeant |
| Unit from Nominal Roll | Australian Army Pay Corps |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
