| Regimental number | 5127 |
| Place of birth | Tibooburra New South Wales |
| Religion | Roman Catholic |
| Occupation | Station hand |
| Address | Tibooburra, New South Wales |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Father, J B Jackson, Tibooburra, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/27/4 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A9 Shropshire on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 10th Battalion |
| Fate | Returned to Australia |
| Date of death | |
| Place of burial | West Terrace Cemetery |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
