| Regimental number | 4696 |
| Place of birth | Perth, Western Australia |
| Religion | Methodist |
| Occupation | Baker |
| Address | Claremont, Western Australia |
| Marital status | Married |
| Age at embarkation | 25 |
| Next of kin | Wife, Mrs Doreen Elsie Clark, Vaucluse Street, Claremont, Western Australia |
| Enlistment date | 13 November 1915 |
| Date of enlistment from Nominal Roll | 28 October 1915 |
| Rank on enlistment | Private |
| Unit name | 28th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/45/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A60 Aeneas on 17 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Motor Transport Company |
| Fate | Returned to Australia 1 June 1919 |
