| Regimental number | 39166 |
| Occupation | Railway fireman |
| Next of kin | Mother, Mrs Ada Clark, Burness Street, Palmerston, Otago |
| Rank on embarkation | Private |
| Unit name | New Zealand Expeditionary Force, 21st Reinforcements, Otago Infantry Battalion, D Company |
| Embarkation details | Unit embarked from Wellington on board Ulimaroa on |
| Final rank | Private |
| Final unit | 3rd Battalion, Otago Infantry Regiment |
| Fate | Died of wounds |
| Age at death from cemetery records | 27 |
| Place of burial | Bailleul Communal Cemetery Extension (Plot III, Row C, Grave No 119), Nord, France |
| Miscellaneous information from cemetery records | Parents: Henry and Ada Clark, Palmerston, Otago |
| Sources | Nominal Roll Vol. 3: Roll 52, p. 14 |