| Regimental number | 12250 |
| Place of birth | Yorkshire England |
| Religion | Church of England |
| Occupation | Motor driver and mechanic |
| Address | Mildura, Victoria |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs M. Jackson, Walnut Avenue, Eighth Street, Mildura, Victoria |
| Enlistment date | 20 December 1915 |
| Date of enlistment from Nominal Roll | 10 December 1915 |
| Rank on enlistment | Motor Transport Driver |
| Unit name | Supply Column 3, Mechanical Transport Reinforcement 1 |
| AWM Embarkation Roll number | 25/29/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A34 Persic on 3 June 1916 |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 2nd A. Sge Bde A.E. |
| Fate | Effective abroad (still overseas) |
