| Regimental number | 4635 |
| Place of birth | Bathurst New South Wales |
| Religion | Church of England |
| Occupation | Mechanical engineer |
| Address | Coogee, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 39 |
| Next of kin | Wife, Mrs Bertha Harriet Clarke, Elm, Rainbow Street, Coogee, Sydney, New South Wales |
| Enlistment date | 21 September 1916 |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/47/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on 25 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 56th Battalion |
| Fate | Returned to Australia 25 January 1919 |
