| Regimental number | 2095 |
| Place of birth | Rokewood Victoria |
| Religion | Presbyterian |
| Occupation | Farmer |
| Address | Ingleside, Rokewood, Victoria |
| Marital status | Single |
| Age at embarkation | 26 |
| Next of kin | Father, William Everit Jacka, Ingleside, Rokewood, Victoria |
| Enlistment date | 11 April 1916 |
| Rank on enlistment | Private |
| Unit name | 39th Battalion, 3rd Reinforcement |
| AWM Embarkation Roll number | 23/56/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A9 Shropshire on 25 September 1916 |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | 39th Battalion |
| Fate | Returned to Australia 27 August 1917 |
