| Regimental number | 6072 |
| Religion | Presbyterian |
| Occupation | Printer |
| Address | Wangaratta, Victoria |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, A A Jackson, Wangaratta, Victoria |
| Previous military service | 58th Infantry |
| Enlistment date | 12 May 1915 |
| Rank on enlistment | Private |
| Unit name | 1 Australian General Hospital 1-6 Special Reinforcements |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on 11 October 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
