| 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 | 13 April 1917 |
| 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 31 October 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 17th Battalion |
| Fate | Returned to Australia 22 August 1919 |
