| Regimental number | 2617 |
| Place of birth | Broken Hill New South Wales |
| Religion | Church of England |
| Occupation | Boundary rider |
| Address | 440 Queen Street, Melbourne, Victoria |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Father, Richard Jacka, Burnerungie Station, Wentworth, New South Wales |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 13th Light Horse Regiment, 23rd Reinforcement |
| AWM Embarkation Roll number | 10/18/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A18 Wiltshire on |
| Rank from Nominal Roll | Gunner |
| Unit from Nominal Roll | 12th Field Artillery Brigade |
| Fate | Returned to Australia |
| Date of death | |
| Place of burial | Fawkner Cemetery |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
