| Regimental number | 3122 |
| Place of birth | Adelaide South Australia |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Ocean Road, Cottesloe Beach, Western Australia |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Father, A W Jackson, Ocean Road, Cottesloe Beach, Western Australia |
| Enlistment date | 5 July 1915 |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/33/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A32 Themistocles on 13 October 1915 |
| Rank from Nominal Roll | Gunner |
| Unit from Nominal Roll | 12th Field Artillery Brigade |
| Fate | Returned to Australia 21 June 1919 |
