| Regimental number | 6484 |
| Place of birth | Sydney New South Wales |
| Religion | Roman Catholic |
| Occupation | Blacksmith |
| Address | Hurstville, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Father, A. Clark, Clermont Street Hurstville Grove, Penshurst, New South Wales |
| Enlistment date | 24 April 1916 |
| Rank on enlistment | Private |
| Unit name | 13th Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/30/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on 7 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 12th Field Ambulance |
| Fate | Effective abroad (still overseas) |
