| Regimental number | 3055 |
| Place of birth | Stepney South Australia |
| Religion | Church of England |
| Occupation | Station manager |
| Address | Portland, Victoria |
| Marital status | Single |
| Age at embarkation | 41 |
| Next of kin | Mother, Mrs. Lucretia Jackman, St. Leonard's, Portland, Victoria |
| Enlistment date | 26 August 1916 |
| Rank on enlistment | Private |
| Unit name | 9th Light Horse Regiment, 23rd Reinforcement |
| AWM Embarkation Roll number | 10/14/5 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A45 Bulla on 16 January 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Veterinary Corps |
| Fate | Returned to Australia 17 July 1919 |
