| Regimental number | 2687 |
| Place of birth | Rushcutters Bay New South Wales |
| Religion | Church of England |
| Occupation | Railway porter |
| Address | Ansell Street, Semaphore, South Australia |
| Marital status | Married |
| Age at embarkation | 28 |
| Next of kin | Wife, Mrs Doris Louisa Jacks, Ansell Street, Semaphore, South Australia |
| Enlistment date | |
| Rank on enlistment | SGT SUPERNUM |
| Unit name | 4th Light Horse Field Ambulance |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A30 Borda on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 7th Field Ambulance |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
