| Regimental number | 3550 |
| Place of birth | Hampstead England |
| Religion | Church of England |
| Occupation | Farmer |
| Address | 49 Constantine Road, Hampstead, London, England |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | T J Jackson, 49 Constantine Road, Hampstead, London, England |
| Enlistment date | 25 April 1915 |
| Rank on enlistment | Private |
| Unit name | Infantry Brigade 7, Field Ambulance 7, Section A |
| AWM Embarkation Roll number | 26/50/1 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A11 Ascanius on 24 May 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 9th Field Ambulance |
| Fate | Returned to Australia 6 September 1919 |
