| Regimental number | 5135 |
| Place of birth | Melbourne Victoria |
| Religion | Church of England |
| Occupation | Plumber |
| Address | 5 Augustus Street, Enmore, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, , Mr J D Jackson, Augustus Street, Enmore, New South Wales |
| Enlistment date | 29 November 1915 |
| Date of enlistment from Nominal Roll | 11 November 1915 |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/21/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Makarini on 1 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Battalion |
| Fate | Returned to Australia 20 April 1919 |