| Regimental number | 3862 |
| Place of birth | Warwickshire England |
| Religion | Church of England |
| Occupation | Lumper |
| Address | East Fremantle, Western Australia |
| Marital status | Married |
| Age at embarkation | 28 |
| Next of kin | Wife, Mrs Isabella Jackson, 3 Tuckfield Street, East Fremantle, Western Australia |
| Enlistment date | 24 November 1915 |
| Rank on enlistment | Private |
| Unit name | 28th Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 23/45/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A28 Miltiades on 12 February 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Cyclists' Battalion |
| Fate | Returned to Australia 3 September 1919 |
