| Regimental number | 6519 |
| Place of birth | Port Fairy Victoria |
| Religion | Roman Catholic |
| Occupation | Butcher |
| Address | Port Fairy, Victoria |
| Marital status | Married |
| Age at embarkation | 36 |
| Next of kin | Wife, Mrs A F Jackson, Sir Charles Hotham Hotel, Spencer Street, Melbourne, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 5th Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/22/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Field Artillery Brigade |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
