| Regimental number | 6032 |
| Place of birth | Brisbane Queensland |
| Religion | Church of England |
| Occupation | Painter |
| Address | Dundas Street, Mosman, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Mother, Mrs M A Jackson, Queanbeyan, New South Wales |
| Enlistment date | 28 February 1916 |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/21/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A18 Wiltshire on 22 August 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Battalion |
| Fate | Returned to Australia 16 March 1918 |