| Regimental number | 5827 |
| Place of birth | Esperance, Western Australia |
| Religion | Methodist |
| Occupation | Electrician |
| Address | c/o Mrs Packer, 266 Oxford Street, Leederville, Western Australia |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, George Clisby, Brookton, GS Railway, Western Australia |
| Enlistment date | 26 April 1916 |
| Date of enlistment from Nominal Roll | 31 March 1916 |
| Rank on enlistment | Private |
| Unit name | 28th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/45/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A23 Suffolk on 13 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 28th Battalion |
| Fate | Returned to Australia 17 June 1918 |