| Regimental number | 4019 |
| Place of birth | Melbourne, Victoria |
| Religion | Methodist |
| Occupation | Butcher |
| Address | 15 Thomas Street, Moonee Ponds, Victoria |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Father, Herbert C Clark, 15 Thomas Street, Moonee Ponds, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 7th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/24/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A40 Ceramic on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
