| Regimental number | 4831 |
| Place of birth | Port Fairy Victoria |
| Religion | Church of England |
| Occupation | Baker |
| Address | 101 Market Street, South Melbourne, Victoria |
| Marital status | Married |
| Age at embarkation | 43 |
| Next of kin | Wife, Mrs M Jackson, 1Ol Market Street, South Melbourne, Victoria |
| Enlistment date | 1 March 1915 |
| Rank on enlistment | Private |
| Unit name | 6th Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/23/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A18 Wiltshire on 7 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 6th Battalion |
| Fate | Returned to Australia 21 July 1917 |
