| Regimental number | 6575 |
| Place of birth | Cumberland New South Wales |
| Religion | Church of England |
| Occupation | Carrier |
| Address | Belmore, New South Wales |
| Marital status | Married |
| Age at embarkation | 37 |
| Next of kin | Wife, Mrs R Jackson, Canterbury Road, Chapel Street Belmore, New South Wales |
| Enlistment date | 21 November 1916 |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/36/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A18 Wiltshire on 7 February 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Service Corps |
| Fate | Returned to Australia 18 July 1919 |
