
| Regimental number | 19096 |
| Place of birth | Cheshire England |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Erragolia, Ponto, New South Wales |
| Marital status | Married |
| Age at embarkation | 43 |
| Next of kin | Wife, Mrs S F Jackson, c/o A J L Stockwell, Wellington, New South Wales |
| Enlistment date | |
| Rank on enlistment | Gunner |
| Unit name | Field Artillery Brigade 7, Battery 28 |
| AWM Embarkation Roll number | 13/35/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A8 Argyllshire on |
| Rank from Nominal Roll | Bombardier |
| Unit from Nominal Roll | 7th Field Artillery Brigade |
| Recommendations (Medals and Awards) |
Parchment Certificate Recommendation date: |
| Fate | Returned to Australia |