| Regimental number | 3374 |
| Place of birth | Sydney New South Wales |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | Cooroy, North Coast Line, Queensland |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Mother, Mrs. Mary Jackson, Onslow Street, Granville, Sydney, New South Wales |
| Enlistment date | 10 February 1917 |
| Rank on enlistment | Private |
| Unit name | 2nd Light Horse Regiment, 28th Reinforcement |
| AWM Embarkation Roll number | 10/7/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A15 Port Sydney on 9 May 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 8th Sanitation Section, A Mounted Division |
| Fate | Returned to Australia 26 July 1919 |
