| Regimental number | 10288 |
| Place of birth | Raddington New South Wales |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Stanmore, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, C F Jackson, 98 Railway Avenue, Stanmore, New South Wales |
| Enlistment date | 22 August 1915 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, April 1916 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on 14 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 7th Field Ambulance |
| Fate | Returned to Australia 4 May 1917 |
| Date of death | 29 May 1953 |
| Place of burial | Rookwood Necropolis |
