| Regimental number | 67407 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Glassblower |
| Address | Melrose Street, Mascot, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, H Jackson, Melrose Street, Mascot, New South Wales |
| Previous military service | 2nd Battalion 1st Infantry |
| Enlistment date | 18 September 1918 |
| Rank on enlistment | Private |
| Unit name | New South Wales Reinforcement 25 |
| AWM Embarkation Roll number | 23/111/6 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Carpentaria on 7 November 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
| Date of death | 22 January 1949 |
| Place of burial | Botany Cemetery |
