| Regimental number | 1582 |
| Place of birth | Adelaide, South Australia |
| Religion | Methodist |
| Occupation | Butcher |
| Address | Clifton Street, Hawthorn, South Australia |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs. Margaret Ann Clark, Clifton Street, Hawthorn, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 3rd Light Horse Regiment, 12th Reinforcement |
| AWM Embarkation Roll number | 10/8/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A2 Geelong on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Cyclists Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
