| Regimental number | 2078 |
| Place of birth | Cessnock New South Wales |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Millfield, New South Wales |
| Marital status | Single |
| Age at embarkation | 36 |
| Next of kin | Mother, Mrs Hannah Clark, Millfield, via Cessnock, New South Wales |
| Enlistment date | 13 March 1916 |
| Rank on enlistment | Private |
| Unit name | 1st Pioneer Battalion, 3rd Reinforcement |
| AWM Embarkation Roll number | 14/13/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A46 Clan MacGillivray on 3 May 1916 |
