| Regimental number | 4227 |
| Place of birth | Malakoff Victoria |
| Religion | Roman Catholic |
| Occupation | Bootmaker |
| Address | 3 Catherine Street, Subiaco, Western Australia |
| Marital status | Married |
| Age at embarkation | 43 |
| Next of kin | Wife, Mrs A Jack, 3 Catherine Street, Subiaco, Western Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/28/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A30 Borda on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Battalion |
| Fate | Returned to Australia |
| Panel number, Roll of Honour, Australian War Memorial | 62 |
| Date of death | |
| Age at death | 57 |
| Place of burial | Fawkner Cemetery, Victoria |