| Regimental number | 7821 |
| Place of birth | Hawthorn Victoria |
| Religion | Methodist |
| Occupation | Gardener |
| Address | Hawthorn, Victoria |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Father, James Phelps Jackson, 6 Carlyle Street, Hawthorn, Victoria |
| Enlistment date | 2 February 1916 |
| Rank on enlistment | Driver |
| Unit name | 2nd Field Company Engineers, Reinforcement 17 |
| AWM Embarkation Roll number | 14/21/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on 14 April 1916 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Hawkes Bay on 20 April 1916 |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 15th Field Company Engineers |
| Fate | Returned to Australia 5 April 1918 |
