| Regimental number | 5866 |
| Place of birth | Liverpool New South Wales |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Club Hotel, Northam, Western Australia |
| Marital status | Married |
| Age at embarkation | 42 |
| Next of kin | W; Mo, Mrs Mary Jackson (address unknown); Mrs Christian Jane Jackson, 25 Green Lance, Stonycroft, Liverpool, England |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 27th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/44/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A16 Port Melbourne on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 27th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
