| Regimental number | 1213 |
| Religion | Church of England |
| Occupation | Plumber's assistant |
| Address | 31 Binning Street, Erskineville, New South Wales |
| Marital status | Married |
| Age at embarkation | 45 |
| Next of kin | Wife, Mrs Harriet Clark, 31 Binning Street, Erskineville, New South Wales |
| Enlistment date | 27 September 1915 |
| Rank on enlistment | Private |
| Unit name | Australian Remount Unit 2, Head-Quarters |
| AWM Embarkation Roll number | 28/3/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A67 Orsova on 10 November 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
