| Regimental number | 13307 |
| Place of birth | Melbourne Victoria |
| Religion | Roman Catholic |
| Occupation | Shunter |
| Address | Fitzroy, Victoria |
| Marital status | Married |
| Age at embarkation | 29 |
| Next of kin | Wife, Mrs M Jackson, 71 Rose Street, Fitzroy, Victoria |
| Enlistment date | 8 July 1915 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Special Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A63 Karoola on 7 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Australian General Hospital |
| Fate | Returned to Australia 28 August 1919 |
