| Regimental number | 5116 |
| Place of birth | Melbourne Vic |
| Religion | Church of England |
| Occupation | Painter |
| Address | 9 Septimus Street, Erskineville, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs J Jackman, 9 Septimus Street, Erskineville, Sydney, New South Wales |
| Enlistment date | 1 September 1915 |
| Rank on enlistment | Private |
| Unit name | 1st Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/18/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT SS Makarini on 1 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Battalion |
| Fate | Returned to Australia 24 January 1919 |
