| Regimental number | 9171 |
| Place of birth | Parramatta New South Wales |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Strathfield, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Father, Charles Jackson, 'Wae-si-si,' Cooper Street, Strathfield, New South Wales |
| Previous military service | 39th Infantry |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Sapper |
| Unit name | Divisional Signal Company 1, Reinforcement 18 |
| AWM Embarkation Roll number | 22/11/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A55 Kyarra on |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 3rd Australian Auxiliary Hospital |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
