| Regimental number | 7063 |
| Place of birth | Fitzroy Victoria |
| Religion | Methodist |
| Occupation | Clerk |
| Address | Waratah, New South Wales |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Father, E K Jacka, Ada Street, Waratah, Newcastle, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/34/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A14 Euripides on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 17th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
