| Regimental number | 6949 |
| Religion | Church of England |
| Occupation | Driver |
| Address | 6 Robin Hood Street, Surry Hills, New South Wales |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs M A Jackson, 6 Robin Hood Street, Surry Hills, New South Wales |
| Enlistment date | 23 September 1916 |
| Rank on enlistment | Private |
| Unit name | 13th Battalion, 22nd Reinforcement |
| AWM Embarkation Roll number | 23/30/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT Port Nicholson on 8 November 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
