| Regimental number | 3021 |
| Place of birth | Stockport England |
| Religion | Church of England |
| Occupation | Postman |
| Address | Riverview College, Lane Cove River, New South Wales |
| Marital status | Single |
| Age at embarkation | 32 |
| Next of kin | Father, Samuel Jackson, 6 Lancashire Hill, Stockport, England |
| Enlistment date | 4 April 1916 |
| Date of enlistment from Nominal Roll | 17 April 1916 |
| Rank on enlistment | Private |
| Unit name | 54th Battalion, 7th Reinforcement |
| AWM Embarkation Roll number | 23/71/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A11 Ascanius on 25 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 51st Battalion |
| Fate | Returned to Australia 15 April 1918 |
