| Regimental number | 6005 |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Spring Hill, Western Australia |
| Marital status | Single |
| Age at embarkation | 43 |
| Next of kin | Mother, Mrs Sarah Clarke, Australind via Bunbury, Western Australia |
| Enlistment date | 21 March 1916 |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/33/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A28 Miltiades on 7 August 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |